Development and validation of an artificial intelligence assisted prenatal ultrasonography screening system for trainees.

OBJECTIVE: Fetal anomaly screening via ultrasonography, which involves capturing and interpreting standard views, is highly challenging for inexperienced operators. We aimed to develop and validate a prenatal-screening artificial intelligence system (PSAIS) for real-time evaluation of the quality of anatomical images, indicating existing and missing structures. METHODS: Still ultrasonographic images obtained from fetuses of 18-32 weeks of gestation between 2017 and 2018 were used to develop PSAIS based on YOLOv3 with global (anatomic site) and local (structures) feature extraction that could evaluate the image quality and indicate existing and missing structures in the fetal anatomical images. The performance of the PSAIS in recognizing 19 standard views was evaluated using retrospective real-world fetal scan video validation datasets from four hospitals. We stratified sampled frames (standard, similar-to-standard, and background views at approximately 1:1:1) for experts to blindly verify the results. RESULTS: The PSAIS was trained using 134 696 images and validated using 836 videos with 12 697 images. For internal and external validations, the multiclass macro-average areas under the receiver operating characteristic curve were 0.943 (95% confidence interval [CI], 0.815-1.000) and 0.958 (0.864-1.000); the micro-average areas were 0.974 (0.970-0.979) and 0.973 (0.965-0.981), respectively. For similar-to-standard views, the PSAIS accurately labeled 90.9% (90.0%-91.4%) with key structures and indicated missing structures. CONCLUSIONS: An artificial intelligence system developed to assist trainees in fetal anomaly screening demonstrated high agreement with experts in standard view identification.

Updated clinical and glycomic features of mannosyl-oligosaccharide glucosidase deficiency: Two case reports.

BACKGROUND: Mannosyl-oligosaccharide glucosidase (MOGS) deficiency is an extremely rare type of congenital disorder of glycosylation (CDG), with only 12 reported cases. Its clinical, genetic, and glycomic features are still expanding. Our aim is to update the novel clinical and glycosylation features of 2 previously reported patients with MOGS-CDG. CASE SUMMARY: We collected comprehensive clinical information, and conducted the immunoglobulin G1 glycosylation assay using nano-electrospray ionization source quadruple time-of-flight mass spectrometry. Novel dysmorphic features included an enlarged tongue, forwardly rotated earlobes, a birth mark, overlapped toes, and abnormal fat distribution. Novel imaging findings included pericardial effusion, a deep interarytenoid groove, mild congenital subglottic stenosis, and laryngomalacia. Novel laboratory findings included peripheral leukocytosis with neutrophil predominance, elevated C-reactive protein and creatine kinase, dyslipidemia, coagulopathy, complement 3 and complement 4 deficiencies, decreased proportions of T lymphocytes and natural killer cells, and increased serum interleukin 6. Glycosylation studies showed a significant increase of hypermannosylated glycopeptides (Glc3Man7GlcNAc2/N2H10 and Man5GlcNAc2/N2H5) and hypersialylated glycopeptides. A compensatory glycosylation pathway leading to an increase in Man5GlcNAc2/N2H5 was indicated with the glycosylation profile. CONCLUSION: We confirmed abnormal glycomics in 1 patient, expanding the clinical and glycomic spectrum of MOGS-CDG. We also postulated a compensatory glycosylation pathway, leading to a possible serum biomarker for future diagnosis.

Direct Photoexcitation of Xanthate Anions for Deoxygenative Alkenylation of Alcohols.

In this report, we identify xanthate salts as a unique class of visible-light-excitable alkyl radical precursors that act simultaneously as strong photoreductants and alkyl radical sources. Upon direct photoexcitation of xanthate anions, efficient deoxygenative alkenylation and alkylation of a wide range of primary, secondary, and tertiary alcohols have been achieved via a one-pot protocol, avoiding any photocatalysts. This method exhibits a broad substrate scope and good functional group tolerance, enabling late-stage functionalization of complex molecules.

Selective deoxygenative alkylation of alcohols via photocatalytic domino radical fragmentations.

The delivery of alkyl radicals through photocatalytic deoxygenation of primary alcohols under mild conditions is a so far unmet challenge. In this report, we present a one-pot strategy for deoxygenative Giese reaction of alcohols with electron-deficient alkenes, by using xanthate salts as alcohol-activating groups for radical generation under visible-light photoredox conditions in the presence of triphenylphosphine. The convenient generation of xanthate salts and high reactivity of sequential C-S/C-O bond homolytic cleavage enable efficient deoxygenation of primary, secondary and tertiary alcohols with diverse functionality and structure to generate the corresponding alkyl radicals, including methyl radical. Moreover, chemoselective radical monodeoxygenation of diols is achieved via selective formation of xanthate salts.

Up-regulation of circRNA_0068481 promotes right ventricular hypertrophy in PAH patients via regulating miR-646/miR-570/miR-885.

CircRNA-0068481 and several miRNAs are important in the pathogenesis of right ventricular hypertrophy (VH), while the inhibition of eye absent transcriptional coactivator and phosphatase 3 (EYA3) was proved to reverse vascular remodelling in rats. In this study, we tried to study the diagnostic value and mechanistic role of circRNA_0068481 in the diagnosis of RVH in PAH patients. qPCR was done to measure circRNA-0068481, miR-646, miR-750, miR-885 and EYA3 mRNA expression. Luciferase assay was done to explore the regulatory relationship between circRNA-0068481/EYA3 and the miRNAs. Western blot was done to measure EYA3 expression in AC16 cells. The expression of circRNA-0068481, miR-646 and miR-570 showed a considerable capability to diagnose RVH in PAH patients. The luciferase activity of circRNA-0068481 was remarkably suppressed by miR-646, miR-570 or miR-885. The luciferase signal of EYA3 was also inhibited by miR-646, miR-570 and miR-885. Up-regulation of circRNA-0068481 expression in AC16 significantly decreased miR-646, miR-570 and miR-885 expression, and up-regulated EYA3 expression, whereas circRNA-0068481 down-regulation significantly increased miR-646, miR-570 and miR-885 expression, and repressed EYA3 expression. CircRNA_0068481 sponged several miRNAs including miR-646, miR-570 and miR-885. These miRNAs were all found to target the expression of EYA3 mRNA, which is involved in the onset of right ventricular hypertrophy. Therefore, it can be concluded that the up-regulation of circRNA_0068481 can predict the diagnosis of right ventricular hypertrophy in pulmonary arterial hypertension patients.

Facile synthesis of graphene oxide/palygorskite composites for Pb(II) rapid removal from aqueous solutions.

As a kind of earth-abundant and cheap natural clay mineral, palygorskite (Pal) was facilely modified by grafting with graphene oxide (GO) to fabricate GO/Pal composites for rapid removal of Pb(II) from aqueous solutions. The results of characterization confirmed that the GO/Pal composites were successfully grafted between GO sheets and Pal nanorods. The effects of pH, adsorbent dosage, adsorption time, initial Pb(II) concentration and temperature on the adsorption of Pb(II) onto the GO/Pal composites as adsorbents were systematically investigated. The maximum adsorption capacity over 106.6 mg/g was obtained within a short adsorption time of less than 1 h even at 298.15 K. The adsorption of Pb(II) was a fast process that more accurately followed the pseudo-second-order kinetic equation. This process also could be described better with the Langmuir equation model than the Freundlich model. The negative values of ΔG° and the positive values of ΔH° and ΔS° indicated that it was a spontaneous, endothermic and entropy-increasing adsorption process. Compared with pristine Pal and GO powders, such the GO/Pal composites as a cost-efficient and eco-friendly adsorbents could significantly improve the adsorption properties of Pb(II) and would have potential application in the industrial wastewater treatment for rapid removal of Pb(II).

[Simulated study on the effects of smoke on Sphagnum spore germination]. / çƒŸæ°”å¯¹æ³¥ç‚­è—“å­¢å­èŒå‘å½±å“çš„æ¨¡æ‹Ÿç ”ç©¶.

Moderate smoke could facilitate seed germination, but its effects on bryophyte spore germination is still unknown. Here, we analyzed the effects of smoke, capsule size and storage time on the spore germination of Sphagnum squarrosum and S. magellanicum, with the capsules of which being collected from two peatlands of the Changbai Mountains. The smoke solution prepared by burning peatland plants was combined with the capsules with different sizes (large, 2.10-2.50 mm in diameter; small, 1.50-1.90 mm in diameter) and storage time (old, being stored for 4.3 or 6.3 a; new, being stored for 0.3 a) to conduct a factorial experiment. The spores were soaked with smoke solution for different durations and then cultured for germination. The results showed that smoke solution affected spore germination. After 10 d cultivation, germination rate of spores soaking with smoke solution for all duration was increased by more than 5-fold, with the small spores having higher germination rate. After 21 d cultivation, the facilitative effect was only observed in moderate soaking (3 d), and spore size showed no effect on germination. Smoke solution could not increase the germination of spores from the capsules with long storage time (4.3 and 6.3 a). Our results indicated that moderate smoke solution soaking might accelerate germination of Sphagnum spores including small pores. In the ecosystems with casual fire disturbance such as peatlands, similar with its effects on the seed plants, smoke might play a key role in the regeneration and persistence of bryophyte population.

Increased intracellular Cl- concentration promotes ongoing inflammation in airway epithelium.

Airway epithelial cells harbor the capacity of active Cl- transepithelial transport and play critical roles in modulating innate immunity. However, whether intracellular Cl- accumulation contributes to relentless airway inflammation remains largely unclear. This study showed that, in airway epithelial cells, intracellular Cl- concentration ([Cl-]i) was increased after Pseudomonas aeruginosa lipopolysaccharide (LPS) stimulation via nuclear factor-κB (NF-κB)-phosphodiesterase 4D (PDE4D)-cAMP signaling pathways. Clamping [Cl-]i at high levels or prolonged treatment with LPS augmented serum- and glucocorticoid-inducible protein kinase 1 (SGK1) phosphorylation and subsequently triggered NF-κB activation in airway epithelial cells, whereas inhibition of SGK1 abrogated airway inflammation in vitro and in vivo. Furthermore, Cl--SGK1 signaling pathway was pronouncedly activated in patients with bronchiectasis, a chronic airway inflammatory disease. Conversely, hydrogen sulfide (H2S), a sulfhydryl-containing gasotransmitter, confers anti-inflammatory effects through decreasing [Cl-]i via activation of cystic fibrosis transmembrane conductance regulator (CFTR). Our study confirms that intracellular Cl- is a crucial mediator of sustained airway inflammation. Medications that abrogate excessively increased intracellular Cl- may offer novel targets for the management of airway inflammatory diseases.

Visible light-driven photocatalytic generation of sulfonamidyl radicals for alkene hydroamination of unsaturated sulfonamides.

A visible light-driven photocatalytic generation of sulfonamidyl radicals, and application to intramolecular alkene hydroamination, has been accomplished, providing a mild and efficient approach to various functionalized isoxazolidines. The success of this protocol is based on the strategy of oxidative deprotonation electron transfer by merging the base and the photocatalyst under visible light irradiation, obviating installation of a photolabile handle or stoichiometric external oxidants.

L-type VDCCs participate in behavioral-LTP and memory retention.

Although L-type voltage-dependent calcium channels (VDCCs) have been reported to display different even contrary actions on cognitive functions and long-term potentiation (LTP) formation, there is little information regarding the role of L-type VDCCs in behavioral LTP, a learning-induced LTP model, in the intact brain of freely behaving animals. Here we investigated the effects of verapamil, a non-selective blocker of L-type VDCCs, on behavioral LTP and cognitive functions. Population spikes (PS) were recorded by using electrophysiological methods to examine the role of verapamil in behavioral LTP in the hippocampal dentate gyrus (DG) region. Y-maze assay was used to evaluate the effects of verapamil on learning and memory. Electron microscope was used to observe the changes on synaptic ultrastructural morphology in hippocampal DG area. We found that intrahippocampal verapamil treatments had no significant changes on the PS amplitude during a 90min recordings period. However, intrahippocampal applications of verapamil, including pre- or post-training, reduced behavioral LTP magnitude and memory retention but did not prevent the induction of behavioral LTP and the acquisition of learning. The saline group with behaving trainings showed obvious increases in the number of smile synapses, the length of active zones and the thickness of postsynaptic density as compared to the baseline group, but verapamil with pre-training treatment almost returned these changes to the baseline levels except for the synaptic interface curvature. In conclusion, our results suggest that L-type VDCCs may only contribute to the magnitude of behavioral LTP and the memory maintenance with an activity-independent relationship. L-type VDCCs may be critical to new information long-term storage rather than acquisition in hippocampus.

Synthesis of Spiro[pyrazolin-3,3'-oxindoles] and 3-Arylcarbonylmethyl Substituted Ylideneoxindoles by 1,3-Dipolar Cycloadditions of 3-Ylideneoxindoles and In-Situ-Generated α-Diazoketones.

An efficient 1,3-dipolar cycloaddition of 3-ylideneoxindoles with in-situ-generated α-diazoketones to potentially biological active spiro[pyrazolin-3,3'-oxindoles] 4 with excellent regioselectivity and diastereoselectivity and synthetically useful building block 3-arylcarbonylmethyl substituted ylideneoxindoles 5 in different conditions has been developed. This method has advantages of mild conditions, simple workup, and wide substrate scopes as well as without using any transition metal catalyst.

[Effect of GSTP1 and MTHFR Gene Polymorphism on Side Effects of HD-MTX in ALL Children].

OBJECTIVE: To Study the effect of C677T and MTHFR gene polymorphism on side effects of HD-MTX in ALL children. METHODS: The gene polymorphism of C677T A303G and MTHFR C677T were detected by PCR in 98 ALL children from January 2014 to January 2016. The side effects during HD-MTX therapy were observed, and the relationship among GSTP1, MTHFR gene polymorphism and incidence of side effect of HD-MTX were analyzed. RESULTS: Among 98 ALL children, the gene variation was observed in 61 ALL children (62.24%). Polymorphism study on C677T A303G showed that the gene frequency of A was 84.69%, while that of G was 15.31%; for polymorphism of MTHFR C677T, gene frequency of C was 66.33%, and that of T was 33.67%. Seven patients(7.14%) experienced with bone marrow supression, 23 patients(23.47%) with liver function damage, 15 patients(15.31%) with renal function damage, 48 patients(48.98%) with gastrointestinal reactions and 46 patients(46.94%) with mucosal lesions. After adjustment of sex, age, risk stratification and dosage of MTX, the gene polymorphism had no significant relationship with bone marrow suppression, gastrointestinal reactions and mucosal lesions(P>0.05). However, the number of the mutant genes had statistically significant relationship with liver and renal function damage(P<0.05). CONCLUSION: The risk of side effects during HD-MTX therapy increases in ALL children with combined mutation of MTHFR and C677T.

Infection by Toxoplasma gondii, a severe parasite in neonates and AIDS patients, causes impaired anion secretion in airway epithelia.

The airway epithelia initiate and modulate the inflammatory responses to various pathogens. The cystic fibrosis transmembrane conductance regulator-mediated Cl(-) secretion system plays a key role in mucociliary clearance of inhaled pathogens. We have explored the effects of Toxoplasma gondii, an opportunistic intracellular protozoan parasite, on Cl(-) secretion of the mouse tracheal epithelia. In this study, ATP-induced Cl(-) secretion indicated the presence of a biphasic short-circuit current (Isc) response, which was mediated by a Ca(2+)-activated Cl(-) channel (CaCC) and the cystic fibrosis transmembrane conductance regulator. However, the ATP-evoked Cl(-) secretion in T. gondii-infected mouse tracheal epithelia and the elevation of [Ca(2+)]i in T. gondii-infected human airway epithelial cells were suppressed. Quantitative reverse transcription-PCR revealed that the mRNA expression level of the P2Y2 receptor (P2Y2-R) increased significantly in T. gondii-infected mouse tracheal cells. This revealed the influence that pathological changes in P2Y2-R had on the downstream signal, suggesting that P2Y2-R was involved in the mechanism underlying T. gondii infection in airways. These results link T. gondii infection as well as other pathogen infections to Cl(-) secretion, via P2Y2-R, which may provide new insights for the treatment of pneumonia caused by pathogens including T. gondii.

Cellular mechanism underlying formaldehyde-stimulated Cl- secretion in rat airway epithelium.

BACKGROUND: Recent studies suggest that formaldehyde (FA) could be synthesized endogeneously and transient receptor potential (TRP) channel might be the sensor of FA. However, the physiological significance is still unclear. METHODOLOGY/PRINCIPAL FINDINGS: The present study investigated the FA induced epithelial Cl(-) secretion by activation of TRPV-1 channel located in the nerve ending fiber. Exogenously applied FA induced an increase of I(SC) in intact rat trachea tissue but not in the primary cultured epithelial cells. Western blot and immunofluorescence analysis identified TRPV-1 expression in rat tracheal nerve ending. Capsazepine (CAZ), a TRPV-1 specific antagonist significantly blocked the I(SC) induced by FA. The TRPV-1 agonist capsaicin (Cap) induced an increase of I(SC), which was similar to the I(SC) induced by FA. L-703606, an NK-1 specific inhibitor and propranolol, an adrenalin ß receptor inhibitor significantly abolished the I(SC) induced by FA or Cap. In the ion substitute analysis, FA could not induce I(SC) in the absence of extracelluar Cl(-). The I(SC) induced by FA could be blocked by the non-specific Cl(-) channel inhibitor DPC and the CFTR specific inhibitor CFTR(i-172), but not by the Ca(2+)-activated Cl(-) channel inhibitor DIDS. Furthermore, both forskolin, an agonist of adenylate cyclase (AC) and MDL-12330A, an antagonist of AC could block FA-induced I(SC). CONCLUSION: Our results suggest that FA-induced epithelial I(SC) response is mediated by nerve, involving the activation of TRPV-1 and release of adrenalin as well as substance P.

Osteopromotive activity of a novel pyrazole carboxamide derivative.

AIMS: To investigate the effect of 1-(4-(tert-butyl)benzyl)-N-(4-methoxyphenyl)-3-phenyl-1H-pyrazole-5-carboxamide (Pyr-C) on the proliferation and osteogenic differentiation of MC3T3-E1 cells. MATERIALS & METHODS: MTT and BrdU incorporation assay were used to determine cell survival and proliferation. The gene expression levels of osteogenic markers were determined using real-time PCR and ALP activity was detected. Western-blot analysis was used to determine the protein expression of BSP and OPN. The long-term effect of Pyr-C on mineralization deposition was measured by Alizarin Red Staining. RESULTS: Pyr-C inhibited cell proliferation and increased ALP activity. Gene expression of ALP, BSP, OCN, Runx2, and Osterix was up-regulated in Pyr-C-induced group. Pyr-C increased the protein expression of BSP at day 7, 14 and 21, and OPN at day 14, 21 and 28. Meanwhile, Pyr-C enhanced the mineral deposition. CONCLUSION: Pyr-C inhibits proliferation and stimulates osteogenic differentiation of MC3T3-E1 cells.

A pilot study evaluating the effect of recombinant human bone morphogenetic protein-2 and recombinant human beta-nerve growth factor on the healing of Class III furcation defects in dogs.

BACKGROUND: The quantity of regenerated bone induced by recombinant human bone morphogenetic protein-2 (rhBMP2) is encouraging, but sometimes the quality is inferior. Recombinant human beta-nerve growth factor (rh beta-NGF) plays a major role in bone remodeling. This study evaluates the quality and quantity of regenerated bone in periodontal regeneration following topical application of the two growth factors to Class III furcation defects. METHODS: Thirty-six inflamed Class III furcation defects were created in six beagle dogs at sites of mandibular premolars 2, 3, and 4, and then biodegradable hydrogel incorporating rhBMP2 and rh beta-NGF was topically applied to the defects. The groupings were as follows: G1, untreated (control group A); G2, carrier alone (control group B); G3, 0.4% rhBMP2 + carrier; G4, 2% rh beta-NGF + carrier; G5, 0.4% rhBMP2 + 2% rh beta-NGF + carrier; and G6, 0.2% rhBMP2 + 1% rh beta-NGF + carrier. Eight weeks after application, the quality and quantity of regenerated tissue were evaluated by scanning electron microscopy observation, calcium/phosphorus ratio analysis, and histologic evaluation. RESULTS: The regenerated bone in G5 exhibited the highest calcium/phosphorus ratio among all groups and showed a denser structure with more calcified substances on the collagen fiber surface than that in the other groups. Histomorphometric analysis revealed that 0.4% rhBMP2 + 2% rh beta-NGF promoted the highest percentage of periodontal regeneration among all groups. CONCLUSION: The results of this pilot study suggest that a topical application of rhBMP2 and rh beta-NGF may improve the quality and quantity of regenerated bone in artificially created Class III furcation defects of beagle dogs.

[Post-operation nursing for patients with autologous transplantation of the microvascular submandibular gland].

OBJECTIVE: To summarize the complications' prevention and nursing experience for patients after autologous transplantation of the microvascular submandibular gland for severe keratoconjunctivis sicca. METHODS: Retrospective analysis of 141 patients(151 sides) after autologous microvascular submandibular gland transfer operation was undertaken to record the timing and incidence of major complications and to summarize the nursing experience. RESULTS: The main complications after the transplantation were: vascular crisis, catheter obstruction, salivary fistula and temporary paralysis of hypoglossal nerve. Related nursing measures in response to these complications were discussed. CONCLUSION: Targeted nursing interventions for patients with autologous transplantation the submandibular gland have a positive effect on the prevention of the surgical complications.