The Application Value of Contrast-Enhanced Ultrasonography in Assessing the Efficacy of Ultrasound-Guided Lauromacrogol Injections in Cesarean Scar Pregnancies.

OBJECTIVE: To investigate the application value of contrast-enhanced ultrasonography (CEUS) in ultrasound-guided lauromacrogol injections in patients with cesarean scar pregnancies (CSP). METHODS: A total of 31 patients diagnosed with CSP, who underwent an ultrasound-guided lauromacrogol injection + curettage in our hospital between February 2019 and December 2020 and had a complete recovery confirmed by a postoperative ultrasound review and serum ß-human chorionic gonadotropin (ß-hCG) assay, were enrolled as the study subjects. According to the volume of intraoperative blood loss and the duration of postoperative vaginal bleeding, the patients were divided into two groups, with 19 in the significantly effective group (Group A) and 12 in the effective group (Group B). The recorded clinical data, including age, duration of amenorrhea, number of pregnancies, number of deliveries, time since last cesarean delivery, number of cesarean deliveries, and preoperative serum ß-hCG levels, were retrospectively analyzed. The morphological indicators in CEUS before the lauromacrogol injection, as well as immediately and 12-24 hours after the injection, were compared between the groups. RESULTS: In Group A, the post-injection CEUS showed no enhancement, single strip enhancement, and sparse punctate enhancement, while in Group B, it showed a more irregular ring and local patch enhancement. In addition, the number of cases where the CEUS showed no enhancement 12-24 hours after the injection was more than that of the immediate CEUS after the injection. In Group A, four (21.1%) cases showed a single strip-like blood flow on the immediate postoperative CEUS, four (21.1%) cases showed a sparsely dotted blood flow on the immediate postoperative CEUS, and three cases turned into no enhancement 12-24 hours after the injection. A total of four cases in Group B showed that the contrast enhancement range 12-24 hours after the injection was reduced compared with that of the immediate contrast after the injection. CONCLUSION: Contrast-enhanced ultrasonography can guide the location selection of the lauromacrogol injection in patients with CSP, and its postoperative morphological indicators can adequately predict the therapeutic effect after curettage and guide clinical management.

Mechanical fatigue of human red blood cells.

Fatigue arising from cyclic straining is a key factor in the degradation of properties of engineered materials and structures. Fatigue can also induce damage and fracture in natural biomaterials, such as bone, and in synthetic biomaterials used in implant devices. However, the mechanisms by which mechanical fatigue leads to deterioration of physical properties and contributes to the onset and progression of pathological states in biological cells have hitherto not been systematically explored. Here we present a general method that employs amplitude-modulated electrodeformation and microfluidics for characterizing mechanical fatigue in single biological cells. This method is capable of subjecting cells to static loads for prolonged periods of time or to large numbers of controlled mechanical fatigue cycles. We apply the method to measure the systematic changes in morphological and biomechanical characteristics of healthy human red blood cells (RBCs) and their membrane mechanical properties. Under constant amplitude cyclic tensile deformation, RBCs progressively lose their ability to stretch with increasing fatigue cycles. Our results further indicate that loss of deformability of RBCs during cyclic deformation is much faster than that under static deformation at the same maximum load over the same accumulated loading time. Such fatigue-induced deformability loss is more pronounced at higher amplitudes of cyclic deformation. These results uniquely establish the important role of mechanical fatigue in influencing physical properties of biological cells. They further provide insights into the accumulated membrane damage during blood circulation, paving the way for further investigations of the eventual failure of RBCs causing hemolysis in various hemolytic pathologies.

Circulating Tumor Cell Phenotyping via High-Throughput Acoustic Separation.

The study of circulating tumor cells (CTCs) offers pathways to develop new diagnostic and prognostic biomarkers that benefit cancer treatments. In order to fully exploit and interpret the information provided by CTCs, the development of a platform is reported that integrates acoustics and microfluidics to isolate rare CTCs from peripheral blood in high throughput while preserving their structural, biological, and functional integrity. Cancer cells are first isolated from leukocytes with a throughput of 7.5 mL h-1 , achieving a recovery rate of at least 86% while maintaining the cells' ability to proliferate. High-throughput acoustic separation enables statistical analysis of isolated CTCs from prostate cancer patients to be performed to determine their size distribution and phenotypic heterogeneity for a range of biomarkers, including the visualization of CTCs with a loss of expression for the prostate specific membrane antigen. The method also enables the isolation of even rarer, but clinically important, CTC clusters.

Cell separation using tilted-angle standing surface acoustic waves.

Separation of cells is a critical process for studying cell properties, disease diagnostics, and therapeutics. Cell sorting by acoustic waves offers a means to separate cells on the basis of their size and physical properties in a label-free, contactless, and biocompatible manner. The separation sensitivity and efficiency of currently available acoustic-based approaches, however, are limited, thereby restricting their widespread application in research and health diagnostics. In this work, we introduce a unique configuration of tilted-angle standing surface acoustic waves (taSSAW), which are oriented at an optimally designed inclination to the flow direction in the microfluidic channel. We demonstrate that this design significantly improves the efficiency and sensitivity of acoustic separation techniques. To optimize our device design, we carried out systematic simulations of cell trajectories, matching closely with experimental results. Using numerically optimized design of taSSAW, we successfully separated 2- and 10-µm-diameter polystyrene beads with a separation efficiency of ∼ 99%, and separated 7.3- and 9.9-µm-polystyrene beads with an efficiency of ∼ 97%. We illustrate that taSSAW is capable of effectively separating particles-cells of approximately the same size and density but different compressibility. Finally, we demonstrate the effectiveness of the present technique for biological-biomedical applications by sorting MCF-7 human breast cancer cells from nonmalignant leukocytes, while preserving the integrity of the separated cells. The method introduced here thus offers a unique route for separating circulating tumor cells, and for label-free cell separation with potential applications in biological research, disease diagnostics, and clinical practice.

Microstructural and Mechanical-Property Manipulation through Rapid Dendrite Growth and Undercooling in an Fe-based Multinary Alloy.

Rapid dendrite growth in single- or dual-phase multicomponent alloys can be manipulated to improve the mechanical properties of such metallic materials. Rapid growth of (αFe) dendrites was realized in an undercooled Fe-5Ni-5Mo-5Ge-5Co (wt.%) multinary alloy using the glass fluxing method. The relationship between rapid dendrite growth and the micro-/nano-mechanical properties of the alloy was investigated by analyzing the grain refinement and microstructural evolution resulting from the rapid dendrite growth. It was found that (αFe) dendrites grow sluggishly within a low but wide undercooling range. Once the undercooling exceeds 250 K, the dendritic growth velocity increases steeply until reaching a plateau of 31.8 ms(-1). The increase in the alloy Vickers microhardness with increasing dendritic growth velocity results from the hardening effects of increased grain/phase boundaries due to the grain refinement, the more homogeneous distribution of the second phase along the boundaries, and the more uniform distribution of solutes with increased contents inside the grain, as verified also by nanohardness maps. Once the dendritic growth velocity exceeds ~8 ms(-1), the rate of Vickers microhardness increase slows down significantly with a further increase in dendritic growth velocity, owing to the microstructural transition of the (αFe) phase from a trunk-dendrite to an equiaxed-grain microstructure.

Fracture mode control: a bio-inspired strategy to combat catastrophic damage.

The excellent mechanical properties of natural biomaterials have attracted intense attention from researchers with focus on the strengthening and toughening mechanisms. Nevertheless, no material is unconquerable under sufficiently high load. If fracture is unavoidable, constraining the damage scope turns to be a practical way to preserve the integrity of the whole structure. Recent studies on biomaterials have revealed that many structural biomaterials tend to be fractured, under sufficiently high indentation load, through ring cracking which is more localized and hence less destructive compared to the radial one. Inspired by this observation, here we explore the factors affecting the fracture mode of structural biomaterials idealized as laminated materials. Our results suggest that fracture mode of laminated materials depends on the coating/substrate modulus mismatch and the indenter size. A map of fracture mode is developed, showing a critical modulus mismatch (CMM), below which ring cracking dominates irrespective of the indenter size. Many structural biomaterials in nature are found to have modulus mismatch close to the CMM. Our results not only shed light on the mechanics of inclination to ring cracking exhibited by structural biomaterials but are of great value to the design of laminated structures with better persistence of structural integrity.