Comparing Sonazoid contrast-enhanced ultrasound to contrast-enhanced CT and MRI for differentially diagnosing renal lesions: a prospective multicenter study.

PURPOSE: To evaluate the diagnostic performance of contrast-enhanced (CE) ultrasound using Sonazoid (SNZ-CEUS) by comparing with contrast-enhanced computed tomography (CE-CT) and contrast-enhanced magnetic resonance imaging (CE-MRI) for differentiating benign and malignant renal masses. MATERIALS AND METHODS: 306 consecutive patients (from 7 centers) with renal masses (40 benign tumors, 266 malignant tumors) diagnosed by both SNZ-CEUS, CE-CT or CE-MRI were enrolled between September 2020 and February 2021. The examinations were performed within 7 days, but the sequence was not fixed. Histologic results were available for 301 of 306 (98.37%) lesions and 5 lesions were considered benign after at least 2 year follow-up without change in size and image characteristics. The diagnostic performances were evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and compared by McNemar's test. RESULTS: In the head-to-head comparison, SNZ-CEUS and CE-MRI had comparable sensitivity (95.60 vs. 94.51%, P = 0.997), specificity (65.22 vs. 73.91%, P = 0.752), positive predictive value (91.58 vs. 93.48%) and negative predictive value (78.95 vs. 77.27%); SNZ-CEUS and CE-CT showed similar sensitivity (97.31 vs. 96.24%, P = 0.724); however, SNZ-CEUS had relatively lower than specificity than CE-CT (59.09 vs. 68.18%, P = 0.683). For nodules > 4 cm, CE-MRI demonstrated higher specificity than SNZ-CEUS (90.91 vs. 72.73%, P = 0.617) without compromise the sensitivity. CONCLUSIONS: SNZ-CEUS, CE-CT, and CE-MRI demonstrate desirable and comparable sensitivity for the differentiation of renal mass. However, the specificity of all three imaging modalities is not satisfactory. SNZ-CEUS may be a suitable alternative modality for patients with renal dysfunction and those allergic to gadolinium or iodine-based agents.

Head-to-head comparison of perfluorobutane contrast-enhanced US and multiparametric MRI for breast cancer: a prospective, multicenter study.

BACKGROUND: Multiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency. PATIENTS AND METHODS: This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. RESULTS: In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online. CONCLUSIONS: PFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020. IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center.

A TiN-based nanophotosensitizer for enhanced photothermal therapy with the aid of ultrasound.

BACKGROUND AND PURPOSE: Targeting and uptake are the most important strategies for enhancing the efficacy of cancer photothermal therapy (PTT) and reducing damage to surrounding normal tissues. In this study, a kind of nanophotosensitizer based on nanobubbles and TiN was prepared for synergetic therapy for hepatocellular carcinoma. METHODS: The photothermal agent titanium nitride (TiN) was wrapped in nanobubbles by membrane hydration method and verified in cells and animals. CCK-8, cell death staining, and JC-1 were used to verify the pernicious effect of photothermal combined with Ultrasound Targeted Nanobubble Destruction (UTND) and then injected into animals through the tail vein to observe its photothermal effect and in vivo inhibitory effect. A hemolysis test and body weight change verified its safety. RESULTS: The average diameter of the novel nanophotosensitizer was 300.3 ± 12.7 nm, with a consistent nanospheres morphology. The UTND technology was utilized to improve the penetration of TiN into tumor cells through the physical energy of ultrasound irradiation. The therapeutic effects of the synergistic therapy of UTND and PTT were verified in vitro and in vivo. CONCLUSION: The research has established NBs@C3F8-TiN as a suitable ultrasound photothermal agent due to its appropriate size and efficient photothermal efficacy for visual photothermal therapy for HCC.

Piezoelectric enhanced sulfur doped graphdiyne nanozymes for synergistic ferroptosis-apoptosis anticancer therapy.

Graphdiyne has excellent potential due to its enzymatic properties. Metal-free sulfur-doped Graphdiyne (S-GDY) has piezoelectric characteristics, and ultrasonic excitation of S-GDY enhances peroxidase activity. It can turn hydrogen peroxide into toxic hydroxyl radicals and induce apoptosis in 4T1 cells. More importantly, the ultrasound (US) enhanced nanozyme induced 4T1 cell ferroptosis by promoting an imbalanced redox reaction due to glutathione depletion and glutathione peroxidase 4 inactivation. S-GDY exhibited enhanced nanozyme activity in vitro and in vivo that may directly trigger apoptosis-ferroptosis for effective tumor therapy. Altogether, this study was expected to provide new insights into the design of piezoelectric catalytic nanozyme and expand their application in the catalytic therapy of tumors.

Analysis of the Diagnostic Value of Transrectal Ultrasonography for Rectal Submucosal Lesions.

Objective: This study aims to investigate the diagnostic value of transrectal ultrasonography for rectal submucosal lesions. Methods: A retrospective analysis was conducted on 132 patients with rectal submucosal lesions admitted to our hospital from June 2018 to May 2022. All patients underwent colonoscopy, miniprobe endoscopic ultrasonography, and transrectal ultrasonography before surgery, obtaining definitive pathological results. The lesions displayed smooth morphological eminence of the mucosa under a colonoscope. Among the patients, there were 76 males and 56 females, with an average age of 50.6 years. Using pathology as the gold standard, the diagnostic accuracy of transrectal ultrasonography and miniprobe endoscopic ultrasonography for rectal submucosal lesions was calculated, and the difference between the two was compared using the chi-square (χ2) test. Results: The overall diagnostic accuracy of transrectal ultrasonography and miniprobe endoscopic ultrasonography for all rectal submucosal lesions was 95.5% and 74.2%, respectively. It was observed that transrectal ultrasonography was superior to miniprobe endoscopic ultrasonography, and the difference was statistically significant (χ2 = 25.48, P < .05). Conclusions: Transrectal ultrasonography demonstrates high diagnostic value for rectal submucosal lesions and may serve as the preferred choice for their examination.

Toward High-Performance Electrochromic Conjugated Polymers: Influence of Local Chemical Environment and Side-Chain Engineering.

Three homologous electrochromic conjugated polymers, each containing an asymmetric building block but decorated with distinct alkyl chains, were designed and synthesized using electrochemical polymerization in this study. The corresponding monomers, namely T610FBTT810, DT6FBT, and DT48FBT, comprise the same backbone structure, i.e., an asymmetric 5-fluorobenzo[c][1,2,5]thiadiazole unit substituted by two thiophene terminals, but were decorated with different types of alkyl chain (hexyl, 2-butyloctyl, 2-hexyldecyl, or 2-octyldecyl). The effects of the side-chain structure and asymmetric repeating unit on the optical absorption, electrochemistry, morphology, and electrochromic properties were investigated comparatively. It was found that the electrochromism conjugated polymer, originating from DT6FBT with the shortest and linear alkyl chain, exhibits the best electrochromic performance with a 25% optical contrast ratio and a 0.3 s response time. The flexible electrochromic device of PDT6FBT achieved reversible colors of navy and cyan between the neutral and oxidized states, consistent with the non-device phenomenon. These results demonstrate that subtle modification of the side chain is able to change the electrochromic properties of conjugated polymers.

Automatic analysis of integrated magnetic resonance and positron emission tomography images improves the accuracy of detection of focal cortical dysplasia type IIb lesions.

We aimed to develop an efficient and objective pre-evaluation method to identify the precise location of a focal cortical dysplasia lesion before surgical resection to reduce medication use and decrease the post-operative frequency of seizure attacks. We developed a novel machine learning-based approach using cortical surface-based features by integrating MRI and metabolic PET to identify focal cortical dysplasia lesions. Significant surface-based features of 22 patients with histopathologically proven FCD IIb lesions were extracted from PET and MRI images using FreeSurfer. We modified significant parameters, trained and tested the XGBoost model using these surface-based features, and made predictions. We detected lesions in all 20 patients using the XGBoost model, with an accuracy of 91%. We used one-way chi-squared test to test the null hypothesis that the population proportion was 50% (p = 0.0001), indicating that our classification of the algorithm was statistically significant. The sensitivity, specificity, and false-positive rates were 93%, 91%, and 9%, respectively. We developed an objective, quantitative XGBoost classifier that combined MRI and PET imaging features to locate focal cortical dysplasia. This automated method yielded better outcomes than conventional visual analysis and single modality quantitative analysis for surgical pre-evaluation, especially in subtle or visually unidentifiable FCD lesions. This time-efficient method would also help doctors identify otherwise overlooked details.

Deep learning Radiomics of shear wave elastography significantly improved diagnostic performance for assessing liver fibrosis in chronic hepatitis B: a prospective multicentre study.

OBJECTIVE: We aimed to evaluate the performance of the newly developed deep learning Radiomics of elastography (DLRE) for assessing liver fibrosis stages. DLRE adopts the radiomic strategy for quantitative analysis of the heterogeneity in two-dimensional shear wave elastography (2D-SWE) images. DESIGN: A prospective multicentre study was conducted to assess its accuracy in patients with chronic hepatitis B, in comparison with 2D-SWE, aspartate transaminase-to-platelet ratio index and fibrosis index based on four factors, by using liver biopsy as the reference standard. Its accuracy and robustness were also investigated by applying different number of acquisitions and different training cohorts, respectively. Data of 654 potentially eligible patients were prospectively enrolled from 12 hospitals, and finally 398 patients with 1990 images were included. Analysis of receiver operating characteristic (ROC) curves was performed to calculate the optimal area under the ROC curve (AUC) for cirrhosis (F4), advanced fibrosis (≥F3) and significance fibrosis (≥F2). RESULTS: AUCs of DLRE were 0.97 for F4 (95% CI 0.94 to 0.99), 0.98 for ≥F3 (95% CI 0.96 to 1.00) and 0.85 (95% CI 0.81 to 0.89) for ≥F2, which were significantly better than other methods except 2D-SWE in ≥F2. Its diagnostic accuracy improved as more images (especially ≥3 images) were acquired from each individual. No significant variation of the performance was found if different training cohorts were applied. CONCLUSION: DLRE shows the best overall performance in predicting liver fibrosis stages compared with 2D-SWE and biomarkers. It is valuable and practical for the non-invasive accurate diagnosis of liver fibrosis stages in HBV-infected patients. TRIAL REGISTRATION NUMBER: NCT02313649; Post-results.

Preparation of a Duplex Nanocrystalline Coating by Magnetron Sputtering and Its Oxidation Performance.

A duplex nanocrystalline coating was prepared in this study by magnetron sputtering on N5 single-crystal super alloy (Ni: Bal, Co: 7.5, Cr: 7.0, Al: 6.2, Ta: 6.5, Re: 3.0, Mo: 1.5 and W: 5.0, wt%). The novel nanocrystalline coating consists of two layers, the inner layer having the same composition with the alloy substrate for avoiding elements inter diffusion while the outer layer has 7.6 wt% higher Al to quickly ensure the formation of a protective Al2O3 layer. Both two layers were deposited within one magnetron sputtering apparatus that contained two targets. The main target was having the same alloy substrate in composition and secondary target with pure Al. The difference in Al content between the two layers was achieved by controlling the secondary target during sputtering. This study revealed a way for preparing a series of similar coatings with varying compositions and improving performance. After oxidation at 1050 °C, a protective Al2O3 layer was quickly formed on the duplex nanocrystalline coating and no TCP phases were detected in the alloy substrate.

Liver Fibrosis with Two-dimensional US Shear-Wave Elastography in Participants with Chronic Hepatitis B: A Prospective Multicenter Study.

Purpose To investigate the diagnostic performance of two-dimensional (2D) shear-wave elastography (SWE) in chronic hepatitis B. Materials and Methods This prospective multicenter study from January 2015 to January 2016 was conducted at 12 hospitals and included 654 participants with chronic hepatitis B who had undergone liver biopsy and 2D SWE examination. Participants were divided into chronic infection and chronic hepatitis groups. The diagnostic performance of 2D SWE was compared with the aspartate amino transferase-to-platelet ratio index (APRI), the Fibrosis-4 index (FIB-4), and transient elastography (TE) by using a DeLong test and was also compared between two subgroups. Dual cutoff values for cirrhosis were determined with multilevel likelihood ratio analysis. Results Overall, 402 participants with chronic hepatitis B were enrolled (154 with chronic infection and 248 with chronic hepatitis). The areas under the receiver operating characteristic curve of 2D SWE (0.87; 95% confidence interval [CI]: 0.83, 0.90) were higher than those of TE (0.80; 95% CI: 0.68, 0.88), APRI (0.70; 95% CI: 0.65, 0.74), and FIB-4 (0.73; 95% CI: 0.69, 0.78) in cirrhosis. The high area under the receiver operating characteristic curve (0.92; 95% CI: 0.87, 0.96) was achieved in the chronic infection group and was significantly higher than that of the chronic hepatitis group (0.84; 95% CI: 0.78, 0.88; P = .017). Dual cutoff values with the likelihood ratios below 0.1 and above 10 (8.4 kPa and 11.0 kPa to rule out and rule in a diagnosis of cirrhosis, respectively) were effectively determined in chronic infection; a total of 81.2% (125 of 154) participants with cirrhosis were definitively diagnosed. Conclusion The performance of two-dimensional (2D) shear-wave elastography (SWE) was higher than that of other noninvasive methods. 2D SWE was most effective in ruling in and ruling out cirrhosis in participants with chronic infection, which may prompt antiviral treatment. © RSNA, 2018 Online supplemental material is available for this article.

Endovascular implantation of 125I seed combined with transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma.

AIM: The purpose of this study was to evaluate the efficacy and safety of the endovascular implantation of 125I seed under ultrasound and x-ray guidance combined with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). PATIENTS & METHODS: The study included 134 pathologically proven or clinically confirmed primary HCC patients with PVTT in our hospital from January 2013 to June 2015. RESULTS & CONCLUSION: Compared with the TACE treatment alone, the combination therapy of 125I seed implantation with TACE significantly prolonged the median survival time and improved the 6-, 12- and 18-month survival rates for HCC patients with PVTT. In addition, the type III PVTT and tumor size were independent predictors for poor prognosis of HCC patients with PVTT.

The Influence of Al and Nb on the Low Oxygen Pressure Pre-Oxidation Behavior of Fe-35Ni-20Cr-xAl-yNb Alloys at 1000 °C.

To investigate the impact of Al and Nb elements on the formation of a protective oxide layer on the surface of Fe-35Ni-20Cr-xAl-yNb (x = 0, 2, 4, 6 wt.%; y = 0, 1, 2 wt.%) alloys, their oxidation behavior was examined at 1000 °C, 10-17 atm. and 10-25 atm. oxygen pressure, and the oxidation mechanism was analyzed by Factsage and Pandat calculations. Enhancing the Al content at 10-17 atm. inhibited the generation of FeCr2O4 on the alloy surface and increased the Al content in the M2O3 layer. When the Al content exceeded 6 wt.%, the oxide film partially peeled off. It was found that the addition of Nb increased the activity of Cr and Al and decreased the activity of Ni and Fe and promoted the formation of Al2O3, and the appearance of Nb2O5 in the subsurface layer increased the density of the oxide film. In addition, under an oxygen pressure of 10-25 atm., the only protective layer on the surface of the alloy comprised of Al2O3. The experimental results demonstrated that the Fe-35Ni-20Cr-4Al-2Nb alloy generated a continuous and dense Al2O3 protective film, and the reduction in oxygen pressure and the addition of Nb elements were favorable for selective external oxidation of Al2O3.

Identification and evaluation of probiotic potential of Bifidobacterium breve AHC3 isolated from chicken intestines and its effect on necrotizing enterocolitis (NEC) in newborn SD rats.

Necrotizing enterocolitis (NEC) is a severe intestinal disease of the newborn infants, associated with high morbidity and mortality. It has been reported that Bifidobacterium could protect the intestinal barrier function and reduce the risk of NEC. This study aimed to evaluate the probiotic potential of Bifidobacterium strains isolated from the chicken intestines and its effect on necrotizing enterocolitis in newborn SD rats. Out of 32 isolates, B. breve AHC3 not only exhibited excellent probiotic potential, including tolerance to artificial simulated gastric conditions, adhesion to HT-29 cells, antioxidant capacity and antibacterial activity, but also possessed reliable safety. Additionally, NEC model was established to further investigate the effect of B. breve AHC3 on necrotizing enterocolitis in newborn SD rats. It was illustrated that administration of B. breve AHC3 significantly not only reduced the incidence of NEC (from 81.25% to 34.38%) (P< 0.05), but also alleviated the severity of ileal injury (P< 0.05). Compared with NEC model, B. breve AHC3 could significantly decrease the level of proinflammatory factor TNF-α (P< 0.05) and increase the level of antiinflammatory factor IL-10 (P< 0.05) in the ileum of NEC rats. Through the intervention of B. breve AHC3, the gray value of inducible nitric oxide synthase (iNOS) in intestinal tissue of NEC rats was significantly reduced (P< 0.05). It was indicated that B. breve AHC3 exhibited prominent probiotic potential and reliable safety. In the neonatal SD rat model of NEC, B. breve AHC3 had an available protective effect on the intestinal injury of NEC, which might be related to reducing the inflammatory reaction in the ileum and inhibiting the expression of iNOS in intestinal tissue cells. B. breve AHC3 could be used as a potential treatment for human NEC.

Efficacy of combining intravenous and topical dexamethasone against postoperative pain and function recovery after total knee arthroplasty: A prospective, double-blind, randomized controlled trial.

BACKGROUND: Dexamethasone is a corticosteroid with powerful anti-inflammatory effects. This study aimed to explore whether combining intravenous and topical dexamethasone could improve postoperative pain, swelling, and function recovery after total knee arthroplasty (TKA). METHODS: In this prospective, double-blind, randomized controlled study, 90 patients undergoing primary unilateral TKA were randomized into a dexamethasone group, which received dexamethasone (10 mg) by periarticular infiltration during surgery, as well as intravenous dexamethasone (10 mg) before tourniquet release and at 12 h postoperatively; or a control group, which received equal volumes of isotonic saline instead of dexamethasone. The primary outcome was postoperative pain, as assessed on the visual analogue scale (VAS). Secondary outcomes were postoperative consumption of morphine hydrochloride for rescue analgesia, postoperative swelling ratio of the thigh, knee, and tibia; functional recovery in terms of total range of motion (ROM) of knee and daily ambulation distance; postoperative inflammation biomarkers levels of C-reactive protein and interleukin-6; and postoperative complications. RESULTS: Resting VAS scores at postoperative 6, 12, and 24 h, and VAS scores during motion at postoperative 2, 6, 12, and 24 h were significantly lower in the dexamethasone group. The dexamethasone group also showed significantly less morphine consumption during the first 24 h after surgery and cumulatively during hospitalization, milder limb swelling at 24 and 48 h postoperatively, greater flexion and total ROM on postoperative day 1, and longer ambulation distance on postoperative days 1 and 2, and lower levels of inflammatory biomarkers on postoperative days 1 and 2. The dexamethasone group had significantly lower incidence of postoperative nausea and vomiting. CONCLUSION: Compared with placebo, the combination of intravenous and topical dexamethasone can reduce pain, swelling, and inflammation after TKA, it also can improve functional recovery and reduce the incidence of postoperative nausea and vomiting.

Predicting malignancy in thyroid nodules based on conventional ultrasound and elastography: the value of predictive models in a multi-center study.

BACKGROUND: This study aimed to establish predictive models based on features of Conventional Ultrasound (CUS) and elastography in a multi-center study to determine appropriate preoperative diagnosis of malignancy in thyroid nodules with different risk stratification based on 2017 Thyroid Imaging Reporting and Data System by the American College of Radiology (ACR TI-RADS) guidelines. METHODS: Five hundred forty-eight thyroid nodules from three centers pathologically confirmed by the cytology or histology were retrospectively enrolled in the study, which were examined by CUS and elastography before fine needle aspiration (FNA) and surgery. Characteristics of CUS of thyroid nodules were reviewed according to 2017 ACR TI-RADS. Binary logistic regression analysis was used to develop the prediction models based on the different risk stratification of CUS features and elastography which were statistically significant. Values of predictive models were evaluated regarding the discrimination and calibration. RESULTS: Binary logistic regression showed that patients' age, taller-than-wider, lobulated or irregular boundary, extra-thyroid extension, microcalcification and the elastic parameter of Virtual touch tissue imaging quantification (VTIQ) max were independent predictors for thyroid malignancy (p < 0.05) in the ACR model and showed the area under the curve (AUC) in training (0.912) and validation cohort (internal and external: 0.877 vs 0.935). Predictive models showed predictors in ACR TR4 and TR5 for malignancy and diagnostic performance of AUC in training, internal and external validation cohort respectively: the VTIQ max (p < 0.001) with AUC of 0.809 vs 0.842 vs 0.705 and the age, taller than wide, VTIQ max variables with AUC of 0.859 vs 0.830 vs 0.906 in validation cohort. All predictive models have better calibration capabilities (p > 0.05). CONCLUSIONS: Predictive models combined CUS and elastography features would aid clinicians to make appropriate preoperative diagnosis of thyroid nodules among different risk stratification. The elastography parameter of VTIQ max has the priority in distinguishing thyroid malignancy with moderately suspicious (ACR TR4).

Evaluation of the Probiotic Potential of Lactobacillus delbrueckii ssp. indicus WDS-7 Isolated from Chinese Traditional Fermented Buffalo Milk In Vitro.

The present study aimed to evaluate the probiotic potential of lactic acid bacteria (LAB) isolated from Chinese traditional fermented buffalo milk. Out of 22 isolates, 11 were putatively identified as LAB preliminarily. A total of six LAB strains displayed strong adhesion to HT-29 cells and all these strains showed preferable tolerance to artificially simulated gastrointestinal juices. WDS-4, WDS-7, and WDS-18 exhibited excellent antioxidant capacities, including DPPH radical, ABTS+ radical, and superoxide anion scavenging activities. Compared with the other two LAB strains, WDS-7 had a stronger inhibition effect on four pathogens. Based on the 16S rRNA gene sequencing and phylogenetic analysis, WDS-7 was identified as Lactobacillus delbrueckii ssp. indicus and selected to assess the potential and safety of probiotics further. The results revealed that WDS-7 strain had a strong capacity for acid production and good thermal stability. WDS-7 strain also possessed bile salt hydrolase (BSH) activity. Compared to LGG, WDS-7 was a greater biofilm producer on the plastic surface and exhibited a better EPS production ability (1.94 mg/ml as a glucose equivalent). WDS-7 was proved to be sensitive in the majority of tested antibiotics and absence of hemolytic activity. Moreover, no production of biogenic amines and ß-glucuronidase was observed in WDS-7. The findings of this work indicated that L. delbrueckii ssp. indicus WDS-7 fulfilled the probiotic criteria in vitro and could be exploited for further evaluation in vivo.

Application of Model-Building Based on Arterial Ultrasound Imaging Evaluation to Predict CHD Risk.

Objective: Atherosclerotic is a chronic systemic disease that may occur in multiple vascular beds, including the carotid arteries, renal arteries, lower limb arteries, and cerebral vessels. Coronary atherosclerosis shares similar risk factors, pathogenesis, and pathophysiological basis with the atherosclerotic lesions of arteries at these sites. Arterial ultrasound assessment data were used to explore the correlation of atherosclerotic disease with CHD lesions and their severity and the number of lesion branches, as well as to evaluate its value in predicting CHD risk, in combination with traditional risk factors. Methods: A total of 363 inpatients with suspected CHD in the Department of Cardiology of the First Hospital of Harbin Medical University from November 2017 to June 2021 were selected. Patient clinical data, blood biochemical examination results, and ultrasound examination of neck vessels, abdominal arteries, and limb arteries were collected to obtain atherosclerosis assessment data. We then compared the differences between the CHD group and the control group, analyzed their correlation with CHD lesions and severity and the number of lesion branches, and evaluated the correlation with the coronary Gensini score. After adjustment for traditional risk factors, logistic regression was applied to analyze the relationship between arterial ultrasound assessment data and the risk of CHD. In addition, ROC plots were drawn to evaluate the risk of arterial ultrasound assessment data, combined with traditional risk factors, to predict CHD. Results: With regard to abnormal blood biochemical index values, differences in lipids, HDL-C, FIB, CK-MB, hs-cTnI, BNP, and GGT were found between the CHD group and the control group. Carotid plaque count, abdominal aortic flow velocity, inferior mesenteric artery flow velocity, classification of the number of stenotic branches of abdominal aortic branch arteries, lower-extremity-artery plaque count, degree of lower-extremity-artery stenosis, and lower-extremity-artery AS were risk factors for arterial ultrasound assessment data of CHD. Carotid plaque count, carotid artery AS, inferior mesenteric artery flow velocity, abdominal aortic flow velocity, abdominal aortic plaque count, abdominal aortic branch artery stenosis branch classification, lower-extremity-artery plaque count, lower-extremity-artery stenosis branch classification, degree of lower-extremity-artery stenosis, and lower-extremity-artery AS, combined with traditional risk factors, were mostly more effective than traditional risk factor models in predicting CHD, its severity, and the number of branch lesions; moreover, the predictive value was higher. Specifically, carotid plaque count, carotid AS, lower-extremity-artery AS, the degree of stenosis of lower-extremity arteries, and abdominal aortic branch artery stenosis branch classification can be used as predictor variables for CHD risk. Among these variables, the carotid plaque count can be used as an independent predictor of CHD. Conclusion: The incidence of arterial intima-media thickening (IMT), plaques, and stenosis can provide a reference for understanding the pattern of systemic atherogenesis and the distribution of atherosclerosis.

'Mito-Bomb': a novel mitochondria-targeting nanosystem for ferroptosis-boosted sonodynamic antitumor therapy.

Mitochondria play an important role in regulating tumor cell death and metabolism so that they can be potential therapeutic targets. Sonodynamic therapy (SDT) represents an attractive antitumor method that induces apoptosis by producing highly toxic reactive oxygen species (ROS). Mitochondria-targeting SDT can cause oxidative damage and improve the efficiency of tumor therapy. However, due to the nonselective distribution of nanosystems and the anti-apoptotic mechanism of cancer cells, the therapeutic effect of SDT is not ideal. Therefore, we proposed a novel mitochondria-targeting nanosystem ('Mito-Bomb') for ferroptosis-boosted SDT. Sonosensitizer IR780 and ferroptosis activator RSL-3 were both encapsulated in biocompatible poly(lactic-co-glycolic acid) (PLGA) nanoparticles to form 'Mito-Bomb' (named IRP NPs). IR780 in this nanosystem was used to mediate mitochondria-targeting SDT. RSL-3 inhibited the activity of GPX4 in the antioxidant system to induce ferroptosis of tumor cells, which could rewire tumor metabolism and make tumor cells extremely sensitive to SDT-induced apoptosis. Notably, we also found that RSL-3 can inhibit hypoxia inducible factor-1α (HIF-1α) and induce ROS production to improve the efficacy of SDT to synergistically antitumor. RSL-3 was applied as a 'One-Stone-Three-Birds' agent for cooperatively enhanced SDT against triple-negative breast cancer. This study presented the first example of RSL-3 boosting mitochondria-targeting SDT as a ferroptosis activator. The 'Mito-Bomb' biocompatible nanosystem was expected to become an innovative tumor treatment method and clinical transformation.

Lung Ultrasound for the Diagnosis and Management of Neonatal Respiratory Distress Syndrome: A Minireview.

Lung ultrasound (LUS) is useful for diagnosis of respiratory distress syndrome in neonates. Recently, it has been proved to play an important role in the management of neonatal respiratory distress syndrome (RDS). It is feasible to grade RDS and select therapeutic modalities accordingly by LUS. The treatment also should be adjusted with the change in ultrasound images. In conclusion, LUS is valuable for the diagnosis and management of neonatal respiratory distress syndrome.