[Comparative study between cardiac catheterization intervention therapy and transthoracic small incision surgery for closure of congenital atrial septal defect by domestic occluder with echocardiographic monitoring].

OBJECTIVE: To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).
 Methods: A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively, and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery. The patients undergone cardiac catheterization intervention therapy were guided under the digital substraction angiography (DSA) and were monitored by transthoracic echocardiography (TTE) in the whole interventional process, and the efficacy was evaluated with TTE. The occlusion of transthoracic small incision surgery was guided under the transesophageal echocardiography (TEE), which was used to monitor the position of occluder and evaluate the efficacy immediately.
 Results: Two kinds of intervention in the occlusion by domestic occluder had achieved satisfactory results in patients with ASD. There was no statistically difference in the longest size of ASD between the 2 intervention methods, while there were statistically differences in the ratio between ASD longest diameter and atrial septal length, and the size of the occlusion, and the disparity between the size of the occluder and ASD longest diameter (D value), respectively (all P<0.05). When the size of arithmetic mean of the ASD was <30 mm, the success rate of the 2 methods was both 100%. When the size of arithmetic mean of the ASD was ≥30 mm, the success rate was 100% in the transthoracic small incision surgery and 50% in the cardiac catheterization intervention therapy.
 Conclusion: Domestic occluder is safe. Compared with the imported one, its cost is lower. When the size of the defects is same, the occlusion is smaller in the transthoracic small incision surgery compared with that in the cardiac catheterization intervention therapy. When the size of arithmetic mean of the ASD is ≥30 mm, the success rate of the transthoracic small incision surgery is higher compared with the cardiac catheterization intervention therapy. When the cardiac catheterization intervention therapy fails, the transthoracic small incision surgery may be a better choice.

Inverse pupil wavefront optimization for immersion lithography.

As the critical dimension of integrated circuits is continuously shrunk, thick mask induced aberration (TMIA) cannot be ignored in the lithography image process. Recently, a set of pupil wavefront optimization (PWO) approaches has been proposed to compensate for TMIA, based on a wavefront manipulator in modern scanners. However, these prior PWO methods have two intrinsic drawbacks. First, the traditional methods fell short in building up the analytical relationship between the pupil wavefront and the cost function, and used time-consuming algorithms to solve for the PWO problem. Second, in traditional methods, only the spherical aberrations were optimized to compensate for the focus exposure matrix tilt and best focus shift induced by TMIA. Thus, the degrees of freedom were limited during the optimization procedure. To overcome these restrictions, we build the analytical relationship between the pupil wavefront and the cost function based on Abbe vector imaging theory. With this analytical model and the Fletcher-Reeves conjugate-gradient algorithm, an inverse PWO method is innovated to balance the TMIA including 37 Zernike terms. Simulation results illustrate that our approach significantly improves image fidelity within a larger process window. This demonstrates that TMIA is effectively compensated by our inverse PWO approach.

Early detection of chemotherapy-induced cardiotoxicity in breast cancer patients: a comprehensive analysis using speckle tracking echocardiography.

Introduction: Chemotherapy-induced cardiotoxicity poses a significant challenge in the treatment of breast cancer, potentially compromising both the efficacy of cancer therapy and cardiac health of patients. This study aimed to enhance the early detection of cardiotoxic effects by integrating advanced imaging modalities and biomarker analysis, thereby facilitating timely interventions to mitigate cardiac risk. Methods: A prospective cohort design was employed, enrolling breast cancer patients scheduled for potentially cardiotoxic chemotherapy regimens. The study utilized a comprehensive diagnostic toolkit, including echocardiography with strain imaging, cardiac MRI, and serial measurements of cardiac biomarkers such as high-sensitivity troponins and natriuretic peptides. Results: The analysis revealed that subtle changes in myocardial strain parameters and early biomarker elevations were predictive of subsequent declines in left ventricular function, preceding conventional echocardiographic evidence of cardiotoxicity. Logistic regression analysis highlighted the additive predictive value of integrating biomarker data with advanced imaging findings to identify patients with the highest risk of significant cardiotoxicity. Discussion: The study concluded that an integrated diagnostic approach, combining detailed imaging assessments with sensitive biomarker analysis, offers a superior strategy for the early detection of chemotherapy-induced cardiotoxicity in breast cancer patients. This proactive diagnostic strategy empowers clinicians to tailor cancer therapy more precisely, balancing oncologic efficacy with cardiovascular safety and underscores the importance of a multidisciplinary approach in the management of patients undergoing potentially cardiotoxic chemotherapy.

miR-99a-5p: A Potential New Therapy for Atherosclerosis by Targeting mTOR and Then Inhibiting NLRP3 Inflammasome Activation and Promoting Macrophage Autophagy.

Objective: MicroRNAs have been revealed to be involved in the development of atherosclerosis. The present study is aimed at exploring the potential of miR-99a-5p as a therapy for atherosclerosis. We suspected that miR-99a-5p might inhibit NLRP3 inflammasome activation and promote macrophage autophagy via constraining mTOR, therefore, alleviating atherosclerosis. Methods: The cell viability in ox-LDL-induced THP-1 macrophages was assessed by CCK-8 assay. Bioinformatic analysis was used to predict the target genes of miR-99a-5p. The binding between miR-99a-5p and mTOR was confirmed by luciferase reporter assay. In vivo, a high-fat-diet-induced atherosclerosis model was established in apolipoprotein E knockout mice. Hematoxylin-eosin, oil red O, and Sirius red staining were performed for the determination of atherosclerotic lesions. MTOR and associated protein levels were detected by Western blot analysis. Results: miR-99a-5p inhibited NLRP3 inflammasome activation and promoted macrophage autophagy by targeting mTOR. Enforced miR-99a-5p significantly reduced the levels of inflammasome complex and inflammatory cytokines. Furthermore, miR-99a-5p overexpression inhibited the expression of mTOR, whereas mTOR overexpression reversed the trend of the above behaviors. In vivo, the specific overexpression of miR-99a-5p significantly reduced atherosclerotic lesions, accompanied by a significant downregulation of autophagy marker CD68 protein expression. Conclusion: We demonstrated for the first time that miR-99a-5p may be considered a therapy for atherosclerosis. The present study has revealed that miR-99a-5p might inhibit NLRP3 inflammasome activation and promote macrophage autophagy by targeting mTOR, therefore, alleviating atherosclerosis.