Evaluation of left ventricular blood flow kinetic energy in patients with acute myocardial infarction by 4D Flow MRI: a preliminary study.

PURPOSE: To evaluate the intracavity left ventricular (LV) blood flow kinetic energy (KE) parameters using four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) in patients with acute myocardial infarction (AMI). METHODS: Thirty AMI patients and twenty controls were examined via CMR, which included cine imaging, late gadolinium enhancement (LGE) and global heart 4D flow imaging. The KE parameters were indexed to LV end-diastolic volume (EDV) to obtain average, systolic and diastolic KE as well as the proportion of LV in-plane KE (%). These parameters were compared between the AMI patients and controls and between the two subgroups. RESULTS: Analysis of the LV blood flow KE parameters at different levels of the LV cavity and in different segments of the same level showed that the basal level had the highest blood flow KE while the apical level had the lowest in the control group. There were no significant differences in diastolic KE, systolic in-plane KE and diastolic in-plane KE between the anterior wall and posterior wall (p > 0.05), only the systolic KE had a significant difference between them (p < 0.05). Compared with those in the control group, the average (10.7 ± 3.3 µJ/mL vs. 14.7 ± 3.6 µJ/mL, p < 0.001), systolic (14.6 ± 5.1 µJ/mL vs. 18.9 ± 3.9 µJ/mL, p = 0.003) and diastolic KE (7.9 ± 2.5 µJ/mL vs. 10.6 ± 3.8 µJ/mL, p = 0.018) were significantly lower in the AMI group. The average KE in the infarct segment was lower than that in the noninfarct segment in the AMI group (49.5 ± 18.7 µJ/mL vs. 126.3 ± 50.7 µJ/mL, p < 0.001), while the proportion of systolic in-plane KE increased significantly (61.8%±11.5 vs. 42.9%±14.4, p = 0.001). CONCLUSION: The 4D Flow MRI technique can be used to quantitatively evaluate LV regional hemodynamic parameters. There were differences in the KE parameters of LV blood flow at different levels and in different segments of the same level in healthy people. In AMI patients, the average KE of the infarct segment decreased, while the proportion of systolic in-plane KE significantly increased.

Three-dimensional arterial spin labeling for the evaluation of the cerebral hemodynamics in ischemic and hemorrhagic Moyamoya disease.

INTRODUCTION: Moyamoya disease (MMD) is a vascular disease with significant risk of mortality due to ischemia or hemorrhage in the brain. The goal of the study was to explore three-dimensional arterial spin labeling (3D-ASL) to improve evaluation of cerebral hemodynamics in patients with MMD. METHODS: Our study included 54 cases of ischemic MMD and 42 cases of hemorrhagic MMD. Dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) and 3D-ASL were performed at 3.0 T. Based on these scans, cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were calculated and compared between patients with different disease subtypes. Receiver operating characteristics (ROC) analysis was used to assess the diagnostic sensitivity and specificity of different imaging procedures and parameters. RESULTS: Our data suggested that CBF in the lesion area was more severely reduced in patients with hemorrhagic MMD than in those with ischemic MMD. The CBF parameter in 3D-ASL diagnosed hemorrhagic and ischemic MMD with a significant sensitivity and specificity of 80.59% and 57.41% respectively, with an area under the curve (AUC) of 0.75. We also found that the relative CBF (rCBF) of 3D-ASL was more pronounced decreased and the relative MTT and TTP of DSC-PWI were significantly increased in patients with hemorrhagic MMD than those with ischemic MMD. Specificity and sensitivity, and AUC of 3D-ASL were better than the comparison of absolute values from DSC-PWI scans. DISCUSSION/CONCLUSION: Our study indicated that 3D-ASL is powerful in differentiating patients with cerebral ischemic or hemorrhagic MMD, providing another diagnostic tool that could potentially improve precision medicine to monitoring MMD patients.

Microwave ablation of multifocal primary liver cancer guided by real-time 3.0T MRI.

OBJECTIVE: To investigate the feasibility and efficacy of real-time 3.0 T magnetic resonance imaging (MRI) guided percutaneous microwave ablation (MWA) in the treatment of multifocal liver cancer. METHODS: A total of 76 lesions in 26 patients with multifocal liver cancer who underwent 3.0 T MRI-guided microwave ablation in our hospital from April 2020 to April 2022 were retrospectively analyzed. The technical success rate, average operation time, average ablation time, and complications were evaluated. The upper abdomen was reviewed by pre- and post-contrast enhanced MRI scan every 1 months after the operation. The short-term curative effect was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria (2020 version), and the local control rate was calculated. RESULTS: All 76 lesions were successfully operated. The technical success rate was 100%, the average operation time was 103.58 ± 18.57 min, the average ablation time of a single lesion was 11.00 ± 4.05 min, and the average ablation power was 43.03 ± 4.45 W. There were no serious complications such as massive bleeding, liver failure, and infection after the operation, except in one case with a small amount of pleural effusion and one case with right upper abdominal pain. The average follow-up time was 13.88 ± 6.62 months. One patient died due to liver failure, and one lesion developed a local recurrence. The local control rate was 98.7%. CONCLUSIONS: MWA of multifocal liver cancer guided by real-time 3.0 T MRI is a safe and feasible technique and has excellent short-term efficacy.

[Bladder wall neourethra technique improves early urinary continence after laparoscopic radical prostatectomy].

OBJECTIVE: To study the effect of the bladder wall neourethra (BWN) technique on early urinary continence after laparoscopic radical prostatectomy (LRP). METHODS: We prospectively selected 40 cases of LRP performed in our hospital from August 2020 to August 2021 and randomly divided them into a BWN group (n = 20) and a control group (n = 20). We recorded the urinary continence rate of the two groups of patients at 7, 30, 90 and 180 days, and measured the maximum urethral pressure (MUP), functional urethral length (FUL) and functional urethral area (UFA) and observed the shape of the neourethra closure by MRI at 1 month after catheter removal. RESULTS: The urinary continence rates were significantly higher in the BWN than in the control group at 7 days (90.0% vs 25.0%, P < 0.001), 30 days (95.0% vs 35.0%, P < 0.001), 90 days (100% vs 60.0%, P < 0.05) and 180 days (100% vs 90.0%, P > 0.05) after catheter removal. No statistically significant difference was observed in MUP between the two groups (P > 0.05). FUL and FUA were remarkably higher in the BWN than in the control group (P < 0.01). MRI showed tight closure of the neourethra in the BWN group in the urine storage period. CONCLUSION: The BWN technique can significantly prolong FUL and improve early urinary continence after LRP.

Metastasis-associated protein 1 (MTA1) regulates the catecholamine production homeostasis via transcriptional repression of aromatic l-amino acid decarboxylase (Aadc) in the interstitial cells of Cajal of mouse prostate.

Based on the lately identified role for the interstitial cells of Cajal (ICCs) of mouse prostate in catecholamine production, as well as the well-established role for the master coregulator metastasis-associated protein 1 (MTA1) in inflammation, we probed into the functional link between aberrant MTA1 expression and pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using both a MTA1-/- mouse model of experimental autoimmune prostatitis (EAP) and an in vitro chronic prostatitis model in cultured murine ICCs. EAP-induced MTA1 expression was enriched in ICCs of mouse prostate. EAP resulted in a higher increase in the pelvic pain response in MTA1-/- mice compared to WT mice. Consistently, the ICCs from MTA1-/- mice produced higher levels of catecholamines upon induction of in vitro chronic prostatitis. Mechanistically, MTA1 could directly suppress the transcription of Aadc, a rate-limiting enzyme during catecholamine synthesis, in a HDAC2-depdendent manner. Importantly, treatment with AADC inhibitor NSD-1015 significantly ameliorated EAP-elicited pain response and catecholamine overactivity in MTA1-/- mice. Taken together, our findings reveal an inherent regulatory role of the MTA1/AADC pathway in the maintenance of catecholamine production homeostasis in prostate ICCs, and also point to a potential use of HDAC inhibitors and/or AADC inhibitors to treat CP/CPPS.

Femtosecond laser hybrid fabrication of a 3D microfluidic chip for PCR application.

Microfluidic chips have gradually become a focus of scientific research. However, the fabrication of key functional components in microfluidic chips is always limited by the existing processing methods. The microfluidic chip is difficult to be three-dimensional (3D) and integrated. In response to the key problems of 3D integrated microfluidic chip fabrication, this paper presents a hybrid method for fabricating a microfluidic chip integrated 3D microchannels and metal microstructures by femtosecond laser wet etch technology and liquid metal injection. The integrated microfluidic chip fabricated by this method is expected to be applied to the core reaction unit of integrated PCR devices.

Underwater superoleophobic and anti-oil microlens array prepared by combing femtosecond laser wet etching and direct writing techniques.

As an important micro-optical device, microlens array (MLA) also has broad applications in aqueous environment apart from atmosphere, such as bioscience research, ocean exploration, and microfluidic systems. However, the surface of the normal MLA is easily polluted by oil contaminations when the MLA is practically applied in a water medium, leading to the loss of its optical imaging ability. Herein, we fabricated a functional MLA with underwater anti-oil and self-cleaning abilities by combining the femtosecond laser wet etching (FLWE) and the femtosecond laser direct writing (FLDW) techniques. The as-prepared close-packed MLA is composed of 10000 single microlenses with the aperture diameter of 50 µm. The surface of each microlens is further textured with micro/nanoparticles. Clear and uniform images could be captured by using the resultant MLA in water, demonstrating great underwater imaging ability. The modulation transfer function value is larger than 0.6 at 55 lp/mm. In addition, the micro/nanostructures endow the as-fabricated MLA surface with underwater superoleophobicity and oil-repellent performance. Various oils can be repelled by the resultant MLA in water. Underwater 1,2-dichloroethane oil droplet on the textured MLA has a contact angle of 158.0 ± 0.5° and a sliding angle of 2.0 ± 0.2°. The underwater superoleophobic MLA also has good mechanical durability. The anti-oil and self-cleaning functions will broaden the applications of the MLA in ocean exploration, bioscience research, microfluidic system, and many underwater MLA-based systems.

Low-cost high integration IR polymer microlens array.

In this Letter, a low-cost refractive convex microlens array device based on infrared a polymer is fabricated by a nanoimprinting technique. The device integrates more than 4000 microlenslets within a footprint of 10 mm×10 mm. The surface quality, spectral transmittance, imaging resolution, and surface damage threshold of the device have been fully characterized. The IR imaging and parallel laser inscription experiments confirm the remarkable optical performance of the fabricated device. Owing to the merits of high optical quality, low fluence lose, and simple fabrication, this device is promising in cutting-edge IR applications, such as IR imaging, laser fabrication, and so on.

Artificial compound eye-tipped optical fiber for wide field illumination.

In this Letter, we present a novel, to the best of our knowledge, component with beam delivering and wide field beam homogenizing functions by grafting an artificial compound eye (ACE) micro-structure onto the polymer optical fiber (POF) end face. The 3D ACE mold is fabricated by femtosecond laser-assisted micro machining, and the ACE micro-structure is transferred onto the end face through high accuracy nano-imprinting. The resultant POF end face integrates over 400 spherical micro-lenses, enabling a 40% enhancement in both the acceptance angle and the effective numerical aperture. Meanwhile, the integrated ommatidia array serves as an outstanding beam homogenizer, shaping the output beam into quasi flat-top distribution, which demonstrates promise in wide field homogeneous illumination, by reflection and transmission imaging experiments in both visible and near infrared bands.

Lens-on-lens microstructures.

Microlenses with multiple focal lengths play an important role in three-dimensional imaging and the real-time detection of unconfined or fluctuating targets. In this Letter, we present a novel method of fabricating lens-on-lens microstructures (LLMs) using a two-step femtosecond laser wet etching process. A 3×3 LLM array was made with a diameter of 129.0 µm. The fabricated LLM has two focal lengths, 80.4 and 188.7 µm, showing excellent two-level focusing and imaging abilities. Its size and focal length can be controlled by adjusting laser power and etching time. Its surface roughness remains about 61 nm. This simple and efficient method for large-scale production of LLMs has potential applications in diverse optical systems.

Fabrication of large-area concave microlens array on silicon by femtosecond laser micromachining.

In this Letter, a novel fabrication of large-area concave microlens array (MLA) on silicon is demonstrated by combination of high-speed laser scanning, which would result in single femtosecond laser pulse ablation on surface of silicon, and subsequent wet etching. Microscale concave microlenses with tunable dimensions and accessional aspherical profile are readily obtained on the 1 cm × 1 cm silicon film, which are useful as optical elements for infrared (IR) applications. The aperture diameter and height of the microlens were characterized and the results reveal that they are both proportional to the laser scanning speed. Moreover, the optical property of high-performance silicon MLAs as a reflective homogenizer was investigated for the visible wavelength, and it can be easily extended to IR light.

High-level integration of three-dimensional microcoils array in fused silica.

Rapid and facile creation of three-dimensional (3D) microcoils array in a "lab-on-a-chip" platform is a big challenge in micromachining. Here we report a method based on an improved femtosecond-laser wet-etch (FLWE) technology and metal-microsolidifying process for the fabrication of 3D microcoils array inside fused silica. Based on this approach, we fabricated microcoil arrays such as 3×3 O-shaped microcoils array and 4×4 liner microcoils array. By injecting high-melting-point alloy, the electrocircuit of microcoils array can hardly be disconnected. The microcoils array also exhibits good uniformity and a high integration level. It shows promise as a real application device.

Large-scale high quality glass microlens arrays fabricated by laser enhanced wet etching.

Large-scale high quality microlens arrays (MLAs) play an important role in enhancing the imaging quality of CCD and CMOS as well as the light extraction efficiency of LEDs and OLEDs. To meet the requirement in MLAs' wide application areas, a rapid fabrication method to fabricate large-scale MLAs with high quality, high fill factor and high uniformity is needed, especially on the glass substrate. In this paper, we present a simple and cost-efficient approach to the development of both concave and convex large-scale microlens arrays (MLAs) by using femtosecond laser wet etching method and replication technique. A large-scale high quality square-shaped microlens array with 512 × 512 units was fabricated.The unit size is 20 × 20 µm² on the whole scale of 1 × 1 cm². Its perfect uniformity and optical performance are demonstrated.

Rapid fabrication of a large-area close-packed quasi-periodic microlens array on BK7 glass.

Large-area close-packed microlens arrays (MLAs) are highly desirable for structured light and integrated optical applications. However, efficient realization of ultralarge area MLAs with a high fill factor is still technically challenging, especially on glass material. In this Letter we propose a high-efficiency MLA fabrication method using single-pulsed femtosecond laser wet etch and close-packed quasi-periodic concave MLAs consisting of three million units fabricated on silica glass within an hour. The fabricated MLAs are demonstrated to have extreme optical smoothness (∼8.5 nm) by an atomic force microscope. It has also been demonstrated that the profile of the quasi-periodic concave structures could be easily tuned by changing the laser scanning speed or the pulse energy. Additionally, the optical performances of the MLA diffusers were investigated by using sharp focusing, high-resolution imaging, and flat-top illumination.

Controllable adhesive superhydrophobic surfaces based on PDMS microwell arrays.

This paper presents a one-step method to fabricate superhydrophobic surfaces with extremely controllable adhesion based on PDMS microwell arrays. The microwell array structures are rapidly produced on PDMS films by a point-by-point femtosecond laser scanning process. The as-prepared superhydrophobic surfaces show water controllable adhesion that ranges from ultrahigh to ultralow by adjusting the extent of overlap of the adjacent microwells, on which the sliding angle can be controlled from 180° (a water droplet can not slide down even when the as-prepared surface is turned upside down) to 3°. A "micro-airbag effect" is introduced to explain the adhesion transition phenomenon of the microwell array structures. This work provides a facile and promising strategy to fabricate superhydrophobic surfaces with controllable adhesion.

The value of CMR Left ventricular strain analysis in evaluating ICM.

The purpose of this article is to investigate the value of cardiac magnetic resonance imaging (CMR) derived left ventricular strain parameters in evaluation of ischemic cardiomyopathy (ICM). Thirty-one ICM patients and nineteen non-cardiomyopathy (non-CM) patients who performed CMR examinations during the same period were selected for this retrospective study. The basic clinical data, CMR left ventricular function parameters, left ventricular strain parameters were compared among the left ventricular ejection fraction (LVEF) preserved ICM group, the LVEF impaired ICM group and the non-CM group. The differences of MyoGCS (-21.9 ± 1.9 vs. -18.9 ± 2.7 P<0.001), MyoGLS (-20.8 ± 2.3 vs. -17.0 ± 2.9 P<0.001) and EndoGLS (-22.2 ± 3.1 vs. -17.6 ± 3.7 P<0.001) between LVEF preserved ICM group and non-CM group were statistically significant, while the differences of left heart function parameters between the two groups were not statistically significant (P > 0.05). The left ventricular strain analysis can be used to assess cardiac functional and morphological alterations in ICM patients prior to changes of left ventricular function parameters, which has high clinical significance.

dMIL-Transformer: Multiple Instance Learning Via Integrating Morphological and Spatial Information for Lymph Node Metastasis Classification.

Automated classification of lymph node metastasis (LNM) plays an important role in the diagnosis and prognosis. However, it is very challenging to achieve satisfactory performance in LNM classification, because both the morphology and spatial distribution of tumor regions should be taken into account. To address this problem, this article proposes a two-stage dMIL-Transformer framework, which integrates both the morphological and spatial information of the tumor regions based on the theory of multiple instance learning (MIL). In the first stage, a double Max-Min MIL (dMIL) strategy is devised to select the suspected top-K positive instances from each input histopathology image, which contains tens of thousands of patches (primarily negative). The dMIL strategy enables a better decision boundary for selecting the critical instances compared with other methods. In the second stage, a Transformer-based MIL aggregator is designed to integrate all the morphological and spatial information of the selected instances from the first stage. The self-attention mechanism is further employed to characterize the correlation between different instances and learn the bag-level representation for predicting the LNM category. The proposed dMIL-Transformer can effectively deal with the thorny classification in LNM with great visualization and interpretability. We conduct various experiments over three LNM datasets, and achieve 1.79%-7.50% performance improvement compared with other state-of-the-art methods.

High-efficiency all fluorescence white OLEDs with high color rendering index by manipulating excitons in co-host recombination layers.

All fluorescence white organic light-emitting diodes (WOLEDs) based on thermally activated delayed fluorescence (TADF) emitters are an attractive route to realize highly efficient and high color quality white light sources. However, harvesting triplet excitons in these devices remains a formidable challenge, particularly for WOLEDs involving conventional fluorescent emitters. Herein, we report a universal design strategy based on a co-host system and a cascaded exciton transfer configuration. The co-host system furnishes a broad and charge-balanced exciton generation zone, which simultaneously endows the devices with low efficiency roll-off and good color stability. A yellow TADF layer is put forward as an intermediate sensitizer layer between the blue TADF light-emitting layer (EML) and the red fluorescence EML, which not only constructs an efficient cascaded Förster energy transfer route but also blocks the triplet exciton loss channel through Dexter energy transfer. With the proposed design strategy, three-color all fluorescence WOLEDs reach a maximum external quantum efficiency (EQE) of 22.4% with a remarkable color rendering index (CRI) of 92 and CIE coordinates of (0.37, 0.40). Detailed optical simulation confirms the high exciton utilization efficiency. Finally, by introducing an efficient blue emitter 5Cz-TRZ, a maximum EQE of 30.1% is achieved with CIE coordinates of (0.42, 0.42) and a CRI of 84 at 1000 cd m-2. These outstanding results demonstrate the great potential of all fluorescence WOLEDs in solid-state lighting and display panels.

Direct fabrication of seamless roller molds with gapless and shaped-controlled concave microlens arrays.

This Letter demonstrates the direct fabrication of gapless concave microlenses on glass cylinders, which can be used as seamless roller molds for the continuous imprinting of large-area microlens arrays. The method involves femtosecond laser exposures followed by a chemical wet-etching process. A honeycomb-like concave microlens array was fabricated on a glass cylinder with a diameter of 3 mm. We demonstrated the flexibility of the method in tuning the shape and depth of the concave structures by the arrangements of the laser exposure spots and laser powers, and examined the replicating ability of the roller mold by the polymer castling method.

Fabrication of three-dimensional helical microchannels with arbitrary length and uniform diameter inside fused silica.

We demonstrate an improved femtosecond laser irradiation followed by chemical etching process to create complex three-dimensional (3D) microchannels with arbitrary length and uniform diameter inside fused silica. A segmented chemical etching method of introducing extra access ports and a secondary power compensation is presented, which enables the fabrication of uniform 3D helical microchannels with length of 1.140 cm and aspect-ratio of 522. Based on this method, a micromixer which consists of a long helical microchannel and a y-tape microchannel was created inside the fused silica. We measured the mixing properties of the micromixer by injecting the phenolphthalein and NaOH solution through the two inlets of the y-tape microchannel. A rapid and efficient mixing was achieved in the 3D micromixer at a low Reynolds number.