Quantitative Analysis of Morphology and Function in the Fetal Heart with Severe Tricuspid Regurgitation by Speckle Tracking Imaging.

Morphology and function in a fetal heart with severe tricuspid regurgitation remains challenging. The aim of this study was to assess cardiac morphology and function in fetuses with severe tricuspid regurgitation by fetal heart quantification (HQ) and to assess the practical value of fetal HQ. Clinical information was analyzed for 63 pregnant women who underwent fetal cardiac ultrasonography. The women were divided into those who had a fetus with severe tricuspid regurgitation (n = 20) and those with a normal fetus (n = 40). The global sphericity index (GSI), fractional area change (FAC), and global longitudinal strain (GLS) of both ventricles and the sphericity index (SI) and fractional shortening (FS) of 24 segments were quantified by fetal HQ using speckle tracking imaging. Fetuses with severe tricuspid regurgitation had a significantly lower GSI (1.14 ± 0.10 vs. 1.26 ± 0.08, p < 0.001) and a higher GSI Z-score (-0.98 ± 1.01 vs. 0.25 ± 0.87, p < 0.001) as well as a significantly lower right ventricular FAC (36.50 ± 7.34% vs. 45.19 ± 3.39%, p < 0.001), FAC Z-score (-1.02 ± 1.41 vs. 0.49 ± 0.74, p < 0.001), and GLS (-21.01 ± 5.66% vs. 45.19 ± 3.49%, p < 0.001). The SI and SI Z-score were significantly lower in segments 1-18 of the right ventricle in fetuses with severe tricuspid regurgitation (p < 0.05); furthermore, FS of segments 1-12 and 19-24 and the FS Z-score of segments 18-24 were significantly lower in fetuses with severe tricuspid regurgitation (p < 0.05). Fetal HQ is useful for evaluation of cardiac morphology and function in fetuses with severe tricuspid regurgitation and can provide important reference information for both clinical diagnosis and treatment.

Neoadjuvant target therapy with ensartinib in lung adenocarcinoma with EML4-ALK fusion variant: a case report and literature review.

Although neoadjuvant target therapy has been used to treat patients with non-small-cell lung cancer (NSCLC), most of these patients have mutations in the epidermal growth factor receptor (EGFR) gene. Few patients to date have received neoadjuvant target therapy for NSCLC containing variants in genes encoding anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs). Herein, we present a 51-year-old man with a lung mass in the left lower lobe with enlarged mediastinal lymph nodes. He was diagnosed with NSCLC after needle lung biopsy, with next-generation sequencing showing an echinoderm microtubule-associated protein-like 4 gene-anaplastic lymphoma kinase (EML4-ALK) fusion variant. The patient received neoadjuvant ensartinib, a second-generation ALK-TKI, for 5 months, followed by successful lobectomy through uniportal video-assisted thoracic surgery and adjuvant ensartinib. To our knowledge, few patients with ALK-positive NSCLC had received neoadjuvant treatment with ensartinib. Findings in this patient may widen indications for neoadjuvant target therapy in the treatment of resectable stage II-IIIA ALK-positive NSCLC.

Homogeneous Synthesis and Electroluminescence Device of Highly Luminescent CsPbBr3 Perovskite Nanocrystals.

Highly luminescent CsPbBr3 perovskite nanocrystals (PNCs) are homogeneously synthesized by mixing toluene solutions of PbBr2 and cesium oleate at room temperature in open air. We found that PbBr2 can be easily dissolved in nonpolar toluene in the presence of tetraoctylammonium bromide, which allows us to homogeneously prepare CsPbBr3 perovskite quantum dots and prevents the use of harmful polar organic solvents, such as N,N-dimethylformamide, dimethyl sulfoxide, and N-methyl-2-pyrrolidone. Additionally, this method can be extended to synthesize highly luminescent CH3NH3PbBr3 perovskite quantum dots. An electroluminescence device with a maximal luminance of 110 cd/m2 has been fabricated by using high-quality CsPbBr3 PNCs as the emitting layer.

Large-scale synthesis of well-dispersed copper nanowires in an electric pressure cooker and their application in transparent and conductive networks.

We present a novel large-scale synthetic method for well-separated copper nanowires (CuNWs) in a commercial electric pressure cooker under mild reaction conditions. CuNWs (∼2.1 g) can be prepared in a batch with the cost of $4.20/g. Well-dispersed polyvinylpyrrolidone-capped CuNWs were obtained via a ligand-exchange method. The transparent and conductive CuNW networks with excellent electrical conductivity and high optical transmittance (30 Ω/□ at 86% transmittance, respectively) were fabricated by a spin-coating process.

Green and facile synthesis of water-soluble Cu-In-S/ZnS core/shell quantum dots.

Water-soluble Cu-In-S/ZnS core/shell quantum dots with a photoluminescence quantum yield up to 38% and an emission peak tunable from 543 to 625 nm have been successfully synthesized. All of the synthetic procedures were conducted in an aqueous solution at 95 °C under open-air conditions. L-Glutathione and sodium citrate were used as the dual stabilizing agents to balance the reactivity between copper and indium ions.

Simple continuous-flow synthesis of Cu-In-Zn-S/ZnS and Ag-In-Zn-S/ZnS core/shell quantum dots.

We present a simple continuous-flow reaction for the synthesis of quaternary Cu-In-Zn-S/ZnS and Ag-In-Zn-S/ZnS core/shell quantum dots (QDs) using inexpensive and low-toxic precursors. The composition and band gap of Cu-In-Zn-S and Ag-In-Zn-S QDs were well controlled by changing the molar ratios of the starting materials. The PL quantum yields of Cu-In-Zn-S/ZnS core/shell quantum dots can reach as high as 40%.

Neoadjuvant radiotherapy plus single-incision thoracoscopic surgery in the treatment of type B3 thymomas.

Background: Although minimally invasive surgery is the standard treatment for thymomas, minimally invasive thymectomy is difficult for patients with type B3 thymomas, especially for giant or aggressive lesions. These tumors are frequently treated with radical radiation therapy or surgery plus adjuvant radiotherapy. Few studies, however, have tested the efficacy of neoadjuvant radiotherapy prior to thoracoscopic surgery. Methods: Patients with type B3 thymomas >5 cm or with infiltrates into vital organs on CT-guided puncture biopsy who underwent neoadjuvant radiotherapy followed by single-incision minimally invasive thymectomy from March 2016 to July 2020 were retrospectively evaluated. Reduction ratios, TNM stage changes according to WHO stage criteria, resectability, long-term survival, and the response in terms of RECIST v1.1 criteria achieved by preoperative RT were analyzed. Results: The 11 patients who underwent neoadjuvant radiotherapy plus minimally invasive thymectomy included five men and six women, of mean age 49.5 years. Four patients had myasthenia gravis. Neoadjuvant radiotherapy consisted of 50 Gy in 25 fractions, with all patients showing varying degrees of lesion reduction after radiotherapy. Surgery was performed about 1 month after neoadjuvant radiotherapy, with none of these patients having severe radiation pneumonitis. All patients underwent radical resection of the tumor and adjacent tissue, with none experiencing tumor seeding or rupture during surgery. The median postoperative hospital stay was 3 days (range: 2-6 days) and the frequency of additional regular analgesics (including those for wound pain and neuralgia) was 2.5 times per person. On follow-up, one patient experienced pleural metastasis and one experienced pulmonary metastasis, with the other nine patients showing no evidence of tumor recurrence. Conclusion: Neoadjuvant radiotherapy followed by minimally invasive surgery was a safe and efficacious procedure for the treatment of type B3 thymomas, with less postoperative pain and faster recovery. This strategy, of tumor shrinkage prior to surgery, may make possible the easier removal of type B3 thymomas by single-incision thoracoscopy.

[Sustained efficacy of alpha-interferon therapy combined with Yixuesheng Capsule in treatment of chronic hepatitis B].

OBJECTIVE: To observe the difference between the combination therapy of alpha-interferon (IFN-alpha) therapy Yixuesheng Capsule and the monotherapy of IFN-alpha in treatment of chronic hepatitis B. METHOD: A total of 288 patients with HBeAg-positive chronic hepatitis B proven by liver biopsy were included in this study. During the individualized therapy, they received hypodermic injection of IFN-alpha 1b, with 5 MU x time(-1) and three times x w(-1). Of them, 125 patients received combination therapy with Yixuesheng Capsule for three months, with 1.0 g/time and three times/d; and 163 patients received only IFN-alpha 1b (the IFN-alpha monotherapy group). After the course of therapy, all patients were followed up for at least 24 months. The intention-to-treat analysis was adopted for statistic analysis. RESULT: The two groups showed no statistical significance by gender, age, liver necroinflammation grading, liver fibrosis staging, serum ALT levels, serum HBV DNA levels and IFN-alpha therapy course. The whole course and the 24-month follow-up visit cover all of 112 patients in the combination treatment group and 141 cases in the IFN-alpha monotherapy group. The response rates of the combination treatment group and the IFN-alpha monotherapy group were 48.0% (60/125) and 35.0% (57/163) (x = 4.980, P = 0.026) at the end of treatment, respectively, 45.6% (57/125) and 33.1% (54/163) (x2 = 4.645, P =0.031) at the end of 12-month-follow-up period, respectively, and 38.4% (48/125) and 32.5% (53/163) (x2 = 1.076, P = 0.300) at the end of 24-month follow-up period, respectively. CONCLUSION: The combination treatment with IFN-alpha and Yixuesheng Capsule shows a slightly better sustained efficacy on HBeAg-positive chronic hepatitis B patients compared with IFN-alpha monotherapy.

Alloyed (ZnSe)(x)(CuInSe2)(1-x) and CuInSe(x)S(2-x) nanocrystals with a monophase zinc blende structure over the entire composition range.

Metastable zinc blende CuInSe(2) nanocrystals were synthesized by a hot-injection approach. It was found that the lattice mismatches between zinc blende CuInSe(2) and ZnSe as well as CuInSe(2) and CuInS(2) are only 2.0% and 4.6%, respectively. Thus, alloyed (ZnSe)(x)(CuInSe(2))(1-x) and CuInSe(x)S(2-x) nanocrystals with a zinc blende structure have been successfully synthesized over the entire composition range, and the band gaps of alloys can be tuned in the range from 2.82 to 0.96 eV and 1.43 to 0.98 eV, respectively. These alloyed (ZnSe)(x)(CuInSe(2))(1-x) and CuInSe(x)S(2-x) nanocrystals with a broad tunable band gap have a high potential for photovoltaic and photocatalytic applications.

Combined Ectopic Variation of the Right Upper Pulmonary Vein and Bronchus.

Ectopia of the right upper pulmonary vein (RUV) is rare and sometimes combined with tracheal bronchus. Such anomalies can affect surgical procedures. We report the case of a 66-year-old woman with lung cancer in which preoperative three-dimensional computed tomography reconstruction and intraoperative images displayed a combined ectopic variation of the RUV and bronchus. The RUV was absent from the anterior hilum, but instead was present in the superior and posterior hilum dispersedly. In addition, the right upper lobe bronchus was ectopic to the lower edge of the "bronchus intermedius." Based on this discovery, video-assisted thoracoscopic lobectomy was successfully performed.

Significantly Improving the Crystal Growth of a Cu2ZnSn(S,Se)4 Absorber Layer by Air-Annealing a Cu2ZnSnS4 Precursor Thin Film.

The crystal quality of a Cu2ZnSn(S,Se)4 (CZTSSe) thin film is crucially important to a high-performance CZTSSe solar cell. After selenization, a bilayer CZTSSe thin film consisting of a large-grain top layer and a small-particle bottom layer is usually observed according to the literature. In this work, a facile air-annealing pretreatment is conducted for a Cu2ZnSnS4 precursor thin film prior to selenization, which can lead to sodium diffusion into the CZTS precursor thin film and surface oxidization of the CZTS thin film. Our experimental results revealed that the Na prediffusion and the surface oxidation of the CZTS precursor thin film can significantly promote the crystal growth of the CZTSSe thin film, which can completely remove the small-particle bottom layer and form a large-grain-spanned CZTSSe thin film. As a result, a photoelectric conversion efficiency of 9.80% was achieved by this method.

CD8+ T Cells Form the Predominant Subset of NKG2A+ Cells in Human Lung Cancer.

Background: NKG2A is an inhibitory receptor of both T cells and natural killer (NK) cells. Persistent activation promotes T cells and NK cells to express NKG2A and results in the progression of chronic infection and cancer. However, the characteristics and subsets of NKG2A+ lymphocytes in human lung cancer are still unclear. Methods: Here, we used the Tumor Immune Estimation Resource database and immune profiling of paired biospecimens to uncover the correlation between NKG2A expression and immune infiltration levels in human cancer as well as the characteristics of NKG2A+ lymphocytes in human lung cancer. Results: We found that KLRC1 expression was especially correlated with CD8+ T-cell infiltration levels in 34 types of human cancer through the Tumor Immune Estimation Resource database. Moreover, NKG2A+ CD8+ T cells were the predominant subset of NKG2A+ lymphocytes in human lung cancer. In contrast, the NKG2A+ NK cells were decreased in tumors compared with the paired normal lung tissue. Tumor-infiltrating NKG2A+ CD8+ T cells expressed tissue-resident memory T cell (TRM cell) and exhausted T-cell markers. Cytokines and cytotoxic molecules secreted by tumor-infiltrating NKG2A+ CD8+ T cells were significantly lower than those secreted by NKG2A- CD8+ T cells in vitro. When stimulated with T-cell receptor activator, tumor-infiltrating NKG2A+ CD8+ T cells could secrete large amounts of granzyme B. Conclusions: Our findings demonstrate that tumor-infiltrating NKG2A+ CD8+ T cells form the predominant subset of NKG2A+ cells in human lung cancer and suggest that targeting NKG2A+ CD8+ T cells is a promising approach for future anti-lung cancer immunotherapy.

Detection of HER2-positive Circulating Tumor Cells Using the LiquidBiopsy System in Breast Cancer.

BACKGROUND: Most previous studies of circulating tumor cells (CTCs) are based on the CellSearch platform, but CellSearch has a number of limitations. This study aimed to use the LiquidBiopsy system and immunofluorescence to test the human epidermal growth factor receptor 2 (HER2) status of CTCs in patients with breast cancer. MATERIALS AND METHODS: The LiquidBiopsy system was used to detect HER2-positive (HER2+) cells in whole blood by microfluidic immunomagnetic bead screening and immunofluorescence assay, according to the manufacturer;s instructions. HER2 expression on CTCs was assessed using the Ariol system, calibrated through spiking experiments of 100 cells (BT474, SKBR3, A431, and MDA-MB-231) and 2.5 × 107 white blood cells/mL from healthy donors. Seventy-one patients with breast cancer and 107 non-cancer donors consented to provide blood. RESULTS: Based on breast cancer cell lines experiments, HER2+ CTCs were defined as CTCs with HER2 immunofluorescence intensity ≥ 3.5 times higher than the CD45 immunofluorescence intensity (100% sensitivity and 99.9% specificity). Among the 71 patients with breast cancer, 31 (43.7%) had HER2+ tumor. Among the HER2+ patients, 41.9% (13/31) were found to be HER2+ based on CTC ≥ 1, and 25.8% (8/31) were positive based on CTC ≥ 3. In HER2-negative patients by pathologic examination, 1 (2.5%) patient was found to have ≥ 3 HER2+ CTCs, whereas 15 (37.5%) patients had ≥ 1 HER2+ CTC. HER2+ CTCs were detected at all stages, even in early breast cancer, but the detection rate was higher in metastatic breast cancer. CONCLUSION: This proof-of-concept study strongly suggests that HER2+ CTCs can be detected using the LiquidBiopsy system.

Phase-Separation-Induced Crystal Growth for Large-Grained Cu2ZnSn(S,Se)4 Thin Film.

Large-grained Cu2ZnSn(S,Se)4 (CZTSSe) absorber layers are highly desirable for high-performance CZTSSe thin film solar cells. However, solution-deposited CZTSSe thin films usually consist of a large-grained top layer and a smaller-grained bottom layer. In this work, we adopt a phase-separation strategy to promote the crystal growth of the CZTSSe thin film. By choosing ZnCl2, SnCl2, CuCl (instead of CuCl2), and thiourea as the starting materials, a Cu2S/SnS/ZnS hybrid precursor thin film can be prepared, the composition of which has been testified by X-ray diffraction, X-ray photoelectron spectroscopy, Raman, and scanning electron microscopy-energy-dispersive spectrometry characterization. Owing to the volume expansion caused by Se incorporation and the high migration abilities of Cu(I) and Sn(II) ions during selenization, large-grained and compact CZTSSe films with a thickness up to 5 µm can be obtained. The corresponding thin film solar cell devices have achieved active power conversion efficiencies above 10% (8.78% for total area), much higher than those of CuCl2-based CZTSSe devices in our lab.

Electrochemical catalysis and thermal stability characterization of laccase-carbon nanotubes-ionic liquid nanocomposite modified graphite electrode.

The hydrophobic carbon nanotubes-ionic liquid (CNTs-IL) gel forms a stable modified film on hydrophobic graphite electrode surface. Laccase immobilized on the CNTs-IL gel film modified electrode shows good thermal stability and enhanced electrochemical catalytic ability. The optimal bioactivity occurs with increasing temperature and this optimum is 20 degrees C higher in comparison to free laccase. The improvement of laccase thermal stability may be due to the microenvironment of hydrophobic CNTs-IL gel on graphite electrode surface. On the other hand, the sensitive detection of oxygen has been achieved due to the feasibility of oxygen reduction by both of laccase and nanocomposite of CNTs-IL gel. Furthermore, the laccase hybrid nanocomposite also shows the fast electrochemical response and high sensitivity to the inhibitors of halide ions with the approximate IC50 of 0.01, 4.2 and 87.5 mM for the fluoride, chloride and bromide ions, respectively. It implies the feasibility of laccase modified electrode as an inhibition biosensor to detect the modulators of laccase.

Peripheral primitive neuroectodermal tumour of left ventricular wall origin: a rare case.

About 7 years ago, we undertook the resection on a patient with a tumour of the wall of the left ventricle near the atrioventricular junction. The pathologic diagnosis after the operation was peripheral primitive neuroectodermal tumour (pPNET) of the left ventricular wall. Microscopically the cell had a small, round, deeply basophilic nucleus, rich in chromatin, and little or no surrounding perikaryon. To our knowledge, no article has ever reported a case of primary myocardial PNET which grew towards the pericardial cavity and there is no adequate data on optimal treatment of PNET in the heart at present. In our case since the tumour recurred in situ and had no evidence of distant metastases, we considered orthotopic cardiac transplantation.

New Insight of Li-Doped Cu2ZnSn(S,Se)4 Thin Films: Li-Induced Na Diffusion from Soda Lime Glass by a Cation-Exchange Reaction.

In our recent report (ACS Appl. Mater. Interfaces 2016, 8, 5308), Li+ ions had been successfully incorporated into the lattice of the selenized Cu2ZnSn(S,Se)4 thin film on a quartz substrate by substituting equivalent Cu+ ions, and Li+ ions was also found to have the little effect on the crystal growth and defect passivation. To further improve the cell performance of Li-doped CZTSSe devices, we conducted the same experiments on the sodium-rich soda-lime glass (SLG) substrate in this study, instead of sodium-free quartz substrate. Surprisingly, only trace amounts of Li (Li/Cu molar ratio ∼1 × 10-4) were detected in the final CZTSSe thin films; meanwhile, a large amount of sodium was present on the surface and at the grain boundaries of the selenized thin films. A Li/Na exchange mechanism is used to explain this phenomenon. Only on the sodium-free substrate can Li+ ions enter the CZTSSe host lattice, and doping Li+ ions on the SLG substrate are nearly identical to doping Na+ ions.

Left bronchial isomerism in a lung cancer patient undergoing right upper pulmonary lobectomy via a thoracoscope.

Left bronchial isomerism is a rare condition characterized by a bronchial structure on the right side that is a mirror image of the left side. In this report, we record our experience with a 62-year-old female lung cancer patient in whom left bronchial isomerism was discovered during surgery using a thoracoscope. A right upper pulmonary lobectomy was successfully completed, the key to which was successful separation of the right upper and middle lobes. As there is a risk of excising the wrong bronchi in such cases, thoracic surgeons need to identify bronchus variations. The optimal method to do this is to use a bronchoscope and computed tomography images of the bronchial tree reconstruction prior to surgery.

Risk factors of lymph node metastasis in lung squamous cell carcinoma of 3 cm or less in diameter.

Through literature review we cannot find an efficient risk factor of lymph node metastasis in lung squamous cell carcinoma (SCC). This study aimed to investigate the risk factors of pathological lymph node status in patients with lung SCC of 3 cm or less in diameter, to provide some reference for the fellow surgeons in the decision of operative option.In total, we analyzed 154 patients with lung SCC of 3 cm or less in diameter who underwent lobectomy or bilobectomy or pneumonectomy with systematic lymph node dissection. The relationship between lymph node status and clinical characteristics were examined.Lymph node metastases were present in 48 patients (31.2%) of the study subjects. Multivariate analysis indicated that, age <60 years old (P = .007), tumor location of central-type (P = .003), tumor long axis >2 cm but ≤3 cm (P = .047) were associated with lymph node metastasis, and their odd ratios (OR) were 3.120, 3.359, and 5.196, respectively. Group analysis of the 74 peripheral lung SCC showed that those with the tumor long axis ≤2 cm had a lower rate of lymph node metastasis (7.9% vs 27.8%, P = .025).Age <60 years old, tumor location of central-type, and tumor long axis >2 cm but ≤3 cm are risk factors of lymph node metastasis in lung SCC. Systematic lymph node dissection or sampling is recommended when tumor central-type location and/or long axis >2 cm in lung SCC are present.

Tuning the Band Gap of Cu2ZnSn(S,Se)4 Thin Films via Lithium Alloying.

Alkali metal doping plays a crucial role in fabricating high-performance Cu(In,Ga)(S,Se)2 and Cu2ZnSn(S,Se)4 (CZTSSe) thin film solar cells. In this study, we report the first experimental observation and characterizations of the alloyed Li(x)Cu(2-x)ZnSn(S,Se)4 thin films. It is found that Cu(+) ions in Cu2ZnSn(S,Se)4 thin films can be substituted with Li(+) ions, forming homogeneous Li(x)Cu(2-x)ZnSn(S,Se)4 (0 ≤ x ≤ 0.29) alloyed thin films. Consequently, the band gap, conduction band minimum, and valence band maximum of Li(x)Cu(2-x)ZnSn(S,Se)4 thin films are profoundly affected by Li/Cu ratios. The band alignment at the Li(x)Cu(2-x)ZnSn(S,Se)4/CdS interface can be tuned by changing the Li/Cu ratio. We found that the photovoltaic parameters of the Li(x)Cu(2-x)ZnSn(S,Se)4 solar cell devices are strongly influenced by the Li/Cu ratios. Besides, the lattice constant, carrier concentration, and crystal growth of Li(x)Cu(2-x)ZnSn(S,Se)4 thin films were studied in detail.