Congenital heart disease-associated pulmonary dysplasia and its underlying mechanisms.

Clinical observation indicates that exercise capacity, an important determinant of survival in patients with congenital heart disease (CHD), is most decreased in children with reduced pulmonary blood flow (RPF). However, the underlying mechanism remains unclear. Here, we obtained human RPF lung samples from children with tetralogy of Fallot as well as piglet and rat RPF lung samples from animals with pulmonary artery banding surgery. We observed impaired alveolarization and vascularization, the main characteristics of pulmonary dysplasia, in the lungs of RPF infants, piglets, and rats. RPF caused smaller lungs, cyanosis, and body weight loss in neonatal rats and reduced the number of alveolar type 2 cells. RNA sequencing demonstrated that RPF induced the downregulation of metabolism and migration, a key biological process of late alveolar development, and the upregulation of immune response, which was confirmed by flow cytometry and cytokine detection. In addition, the immunosuppressant cyclosporine A rescued pulmonary dysplasia and increased the expression of the Wnt signaling pathway, which is the driver of postnatal lung development. We concluded that RPF results in pulmonary dysplasia, which may account for the reduced exercise capacity of patients with CHD with RPF. The underlying mechanism is associated with immune response activation, and immunosuppressants have a therapeutic effect in CHD-associated pulmonary dysplasia.

Pulmonary Hypoplasia Resulting from Pulmonary Artery Banding in Infancy: A Neonatal Rat Model Study.

The aim of this study was to establish a neonatal rat model of decreased pulmonary blood flow (PBF) for studying pulmonary pathophysiological changes in newborn lung development with reduced PBF. Horizontal thoracotomy surgery with banding of the main pulmonary artery (PA) was performed on 30 rats in the PA banding (PAB) group and without banding on another 30 rats in the sham group within 6 h after birth. The body growth and mortality were recorded. Constriction of PA was checked by echocardiography on postnatal day 7 (P7). Lung morphology was assessed with computed tomography scanning and three-dimensional reconstruction. Histological differences of two groups were evaluated using hematoxylin and eosin (H&E) staining, Masson's trichrome staining, TdT-mediated dUTP nick-end labeling assay, and CD31 labeling with microscopic examination. PA ultrasound confirmed the establishment of constriction on P7. Relative to the sham group, the neonates' physical growth, survival fraction, and lung geometry volume were decreased in the PAB group over time (p < 0.05). Histologic appearance with reduced PBF characterized a markedly simplified alveolarization with noted lower radial alveolar count and alveolar septal thickness in the PAB group (p < 0.0001), pulmonary arteries with thinner/uneven membranous layers and smaller lumina. The deficient alveolar capillary bed, enhanced pulmonary collagen deposition, and increased apoptotic alveolar epithelium were significant in the PAB group compared to the sham group (p < 0.0001). A neonatal rat PAB model demonstrated that PBF reduction during early infancy impairs alveolarization and pulmonary microvasculature.

Ultrastable Laurionite Spontaneously Encapsulates Reduced-dimensional Lead Halide Perovskites.

Reduced dimensional lead halide perovskites (RDPs) have attracted great research interest in diverse optical and optoelectronic fields. However, their poor stability is one of the most challenging obstacles prohibiting them from practical applications. Here, we reveal that ultrastable laurionite-type Pb(OH)Br can spontaneously encapsulate the RDPs in their formation solution without introducing any additional chemicals, forming RDP@Pb(OH)Br core-shell microparticles. Interestingly, the number of the perovskite layers within the RDPs can be conveniently and precisely controlled by varying the amount of CsBr introduced into the reaction solution. A single RDP@Pb(OH)Br core-shell microparticle composed of RDP nanocrystals with different numbers of perovskite layers can be also prepared, showing different colors under different light excitations. More interestingly, barcoded RDP@Pb(OH)Br microparticles with different parts emitting different lights can also be prepared. The morphology of the emitting microstructures can be conveniently manipulated. The RDP@Pb(OH)Br microparticles demonstrate outstanding environmental, chemical, thermal, and optical stability, as well as strong resistance to anion exchange processes. This study not only deepens our understanding of the reaction processes in the extensively used saturation recrystallization method but also points out that it is highly possible to dramatically improve the performance of the optoelectronic devices through manipulating the spontaneous formation process of Pb(OH)Br.

Temperature dependent molecular fluorescence of [Agm]n+ quantum clusters stabilized by phosphate glass networks.

Molecule like silver quantum clusters ([Agm]n+ QCs) exhibit an ultrasmall size confinement resulting in efficient broadband fluorescence. However, free [Agm]n+ QCs are also chemically active, so their stabilization is required for practical applications. We report in this work a phosphate oxyfluoride glass network enabled stabilization strategy of [Agm]n+ QCs. A series of silver-doped P2O5-ZnF2-xAg glasses were prepared by a conventional melt-and-quench method. The NMR and XPS results reveal that two types of [P(O,F)4] tetrahedrons (Q1, Q2) form chain structures and Zn(iv) connects [P(O,F)4] chains into a 3-dimension network in the glasses. The frameworks with limited void spaces were designed to restrict the polymerization degree, m, of [Agm]n+ QCs; the negatively charged tetrahedrons were designed to restrict the charge, n, of [Agm]n+ QCs. Through optical and mass spectroscopy studies, silver quantum clusters, [Ag2]2+ and [Ag4]2+, were identified to be charge compensated by [ZnO4] tetrahedrons and surrounded with [P(O,F)4] complex anions. The fluorescence thus gives high quantum efficiencies of 55.2% and 83.4%, for P2O5-ZnF2-xAg glass stabilized [Ag2]2+ and [Ag4]2+ QCs, respectively. This further reveals that the peak fixed fluorescence of [Ag2]2+ and [Ag4]2+ can be described by molecular fluorescence mechanisms. These are parity-allowed singlet-singlet transitions (S1 → S0), parity-forbidden triplet-singlet transitions (T1 → S0) and intersystem crossings between singlets (S1) and triplets (T1). The phonon coupled intersystem crossing between singlets (S1) and triplets (T1) determines the phosphate stabilized [Ag4]2+ QCs to exhibit a series of temperature dependent fluorescence behaviors. These include fluorescence intensity (at 50-200 K), intensity ratio (FIR) (at 50-200 K), peak shift (at 100-300 K) and lifetime (at 300-450 K) with maximum sensitivities of 1.27% K-1, 0.94% K-1, 0.29% K-1 and 0.41% K-1, respectively. Therefore, phosphate stabilized [Ag4]2+ QCs can be applied as temperature sensing probes, especially at low temperatures (10-300 K) and for color-based visualized temperature sensors.

Phase separation strategy to facilely form fluorescent [Ag2]2+/[Agm]n+ quantum clusters in boro-alumino-silicate multiphase glasses.

By adjusting the content of ZnF2-SrF2/ZnO-SrO, a series of SiO2-Al2O3-B2O3-Na2O-ZnO/ZnF2-SrO/SrF2-Ag multiphase glasses was designed and prepared via a melt-quenching method. Under a phase separation strategy, negatively charged tetrahedrons ([BO4]-, [ZnO4]2-, and [AlO4]-) can be generated to stabilize different silver species (Ag+ ions; [Ag2]2+ pairs; [Agm]n+ quantum clusters ([Agm]n+ QCs)) in B2O3-rich and ZnO-Al2O3 rich sub-phases. The B2O3-rich sub-phase has a high solubility for Ag+ ions and [Agm]n+ QCs. The fluoride-rich phase shows a good ability to extract Na+ from the B2O3-rich sub-phase, significantly affects the solubility of Ag+ in the B2O3-rich sub-phase, and eventually determines the aggregation from Ag+ ions and Ag0 atom to [Agm]n+ QCs. The ZnO-Al2O3-rich or ZnO-SiO2-rich (i.e. SiO2-rich in GZnOSrO) phase has a relatively high solubility for [Ag2]2+ pairs. The Ag+/[Ag2]2+/[Agm]n+ QC fluorescent centers were identified by spectroscopic analysis, where the fluorescence bands are located in the ultraviolet, green-white and orange spectral regions, respectively. The fluorescent quantum yield (QY) of the [Agm]n+ QCs can be improved to 55.7%, and the combination of these three luminescent centers can achieve white light emission.

A surgical mouse model of neonatal right ventricular outflow tract obstruction by pulmonary artery banding.

BACKGROUD: Diseased animal models play an extremely important role in preclinical research. Lacking the corresponding animal models, many basic research studies cannot be carried out, and the conclusions obtained are incomplete or even incorrect. Right ventricular (RV) outflow tract (RVOT) obstruction leads to RV pressure overload (PO) and reduced pulmonary blood flow (RPF), which are 2 of the most important pathophysiological characteristics in pediatric cardiovascular diseases and seriously affect the survival rate and long-term quality of life of many children. Due to the lack of a neonatal mouse model for RVOT obstruction, it is largely unknown how RV PO and RPF regulate postnatal RV and pulmonary development. The aim of this study was to construct a neonatal RVOT obstruction mouse model. METHODS AND RESULTS: Here, we first introduced a neonatal mouse model of RVOT obstruction by pulmonary artery banding (PAB) on postnatal day 1. PAB induced neonatal RVOT obstruction, RV PO, and RPF. Neonatal RV PO induced cardiomyocyte proliferation, and neonatal RPF induced pulmonary dysplasia, the 2 features that are not observed in adult RVOT obstruction. As a result, PAB neonates exhibited overall developmental dysplasia, a sign similar to that of children with RVOT obstruction. CONCLUSIONS: Because many pediatric cardiovascular diseases are associated with RV PO and RPF, the introduction of a neonatal mouse model of RVOT obstruction may greatly enhance our understanding of these diseases and eventually improve or save the lives of many children.

Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model.

Right ventricular (RV) volume overload (VO) is common in children with congenital heart disease. In view of distinct developmental stages,the RV myocardium may respond differently to VO in children compared to adults. The present study aims to establish a postnatal RV VO model in mice using a modified abdominal arteriovenous fistula. To confirm the creation of VO and the following morphological and hemodynamic changes of the RV, abdominal ultrasound, echocardiography, and histochemical staining were performed for 3 months. As a result, the procedure in postnatal mice showed an acceptable survival and fistula success rate. In VO mice, the RV cavity was enlarged with a thickened free wall, and the stroke volume was increased by about 30%-40% within 2 months after surgery. Thereafter, the RV systolic pressure increased, corresponding pulmonary valve regurgitation was observed, and small pulmonary artery remodeling appeared. In conclusion, modified arteriovenous fistula (AVF) surgery is feasible to establish the RV VO model in postnatal mice. Considering the probability of fistula closure and elevated pulmonary artery resistance, abdominal ultrasound and echocardiography must be performed to confirm the model status before application.

Development and validation of a prognostic nomogram for predicting cancer-specific survival in advanced endometrial carcinoma after surgery: a retrospective analysis of the SEER Database.

OBJECTIVE: We aimed to construct and validate a prognostic nomogram to predict cancer-specific survival (CSS) after surgery in patients with advanced endometrial carcinoma (EC). DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: The Surveillance, Epidemiology, and End Results (SEER) Database contains cancer incidence and survival data from population-based cancer registries in the USA. A total of 5445 patients from the SEER Database diagnosed with advanced EC between 2004 and 2015 were included and randomised 7:3 into a training cohort (n=3812) and a validation cohort (n=1633). OUTCOME MEASURE: CSS. RESULTS: The nomograms for CSS included 10 variables (positive regional nodes, age, tumour size, International Federation of Gynecology and Obstetrics (FIGO) stage, grade, ethnicity, income, radiation, chemotherapy and historical stage) based on the forward stepwise regression results. They revealed discrimination and calibration using the concordance index (C-index) and area under the time-dependent receiver operating characteristic curve, with a C-index value of 0.7324 (95% CI=0.7181 to 0.7468) and 0.7511 (95% CI=0.7301 to 0.7722) for the training and validation cohorts, respectively. Using calibration plots, a high degree of conformance was shown between the predicted and observed results. Additionally, a comparison of the nomogram and FIGO staging based on changes in the C-index, net reclassification index and integrated discrimination improvement demonstrated that the nomogram had better accuracy and efficacy. CONCLUSIONS: We successfully constructed an accurate and effective nomogram to predict CSS in patients with advanced EC, which may help clinicians determine optimal individualised treatment strategies for patients with advanced EC. The predictive performance of the nomogram was evaluated thoroughly, but only internally. Therefore, further validation using different data sources is warranted in future related studies.

[Value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography in differentiation of malignant from benign gastrointestinal diseases].

OBJECTIVE: To explore the value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography ((18)F-FDG PET-CT) in differentiation of malignant from benign gastrointestinal diseases. METHODS: Sixty five patients with suspected gastrointestinal lesions underwent dual-time-point (18)F-FDG PET-CT imaging. Standardized uptake value (SUV) was calculated for semi-quantitative assessment. The SUV of the two acquisitions were signed SUV(early) and SUV(delayed), respectively. Then the change of SUVmax (ΔSUVmax) was calculated. The ROC curves of the SUV(early), SUV(delayed) and ΔSUV were drawn to find the best cut-off point value for differential diagnosis, and then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated, respectively. RESULTS: Of the malignant lesions, the SUVmax in delayed imaging were significantly higher than those in early imaging, while there were no significant differences of SUVmax between the two images of the benign lesions. The ΔSUVmax of the malignant lesions were significantly higher than that of the benign ones. Taking the SUVmax higher than 9.2 in early imaging as positive diagnostic criteria, the sensitivity was 72.7%, the specificity was 85.7%, the positive predictive value was 91.4%, the negative predictive value was 60.0%, and the accuracy was 76.9%. Taking the SUVmax higher than 10.9 in delayed imaging as positive diagnostic criteria, the sensitivity was 75.0%, the specificity was 90.5%, the positive predictive value was 94.3%, the negative predictive value was 63.3%, and the accuracy was 80.0%. Taking the ΔSUVmax higher than 5.1% as positive diagnostic criteria, the sensitivity was 95.5%, the specificity was 85.7%, the positive predictive value was 93.3%, the negative predictive value was 90.0%, and the accuracy was 92.3%. The accuracy of dual-time-point (18)F-FDG PET-CT imaging was significantly higher than that of single-time point (18)F-FDG PET-CT imaging. CONCLUSION: Dual-time-point (18)F-FDG PET-CT imaging is a useful method for differentiating malignant from benign gastrointestinal diseases, and it is superior to the single-time point (18)F-FDG PET-CT imaging.

Photoswitchable probe with distinctive characteristics for selective fluorescence imaging and long-term tracing.

A photo-switchable and high-contrast bio-imaging indicator 4,4'-(1E,1'E)-(4,4'-(cyclopentene-1,2-diyl)bis(5-methylthiophene-4,2-diyl))bis(methan-1-yl-1-ylidene)bis(azan-1-yl-1-ylidene)bis(2-(benzo[d]thiazol-2-yl)phenol) (BMBT) has been demonstrated, by integrating photochromophore with excited-state intramolecular proton transfer (ESIPT) moiety. The ability of reversible emission switching enables arbitrarily selective labeling or concealing of cells simply by controlling light irradiation. Besides, when the emission was switched on, BMBT is demonstrated to exhibit unique characteristics of aggregation induced emission (AIE), providing a high on-off ratio for favorable bio-imaging. Thus, the non-labeling and easily-controlled selective imaging, as well as good biocompatibility indicates BMBT to be a favorable cell probe with great potentials for functional bio-imaging fluorophore.

Structural Origins of RF3/NaRF4 Nanocrystal Precipitation from Phase-Separated SiO2-Al2O3-RF3-NaF Glasses: A Molecular Dynamics Simulation Study.

Oxyfluoride glass-ceramics with RF3 or NaRF4 (R3+: rare earth elements) nanocrystals are considered as favorable hosts for luminescence applications. In this work, we utilized large-scale molecular dynamics (MD) simulations with effective partial charge potentials to study a series of oxyfluoride glasses that are of interest to the precipitation of RF3 or NaRF4 nanocrystals as previous experiment results suggested. The results show that phase separation exists in all glass compositions with fluoride-rich regions made up of R3+, Na+, and F- and oxide-rich regions consisting of aluminosilicate networks. These fluoride-enriched regions can serve as the precursor for RF3, cubic and hexagonal NaRF4, and NaF crystal precipitation. The results also confirm that the concentration of Na+ in the fluoride phase plays a key role in determining the crystal phases (RF3, NaRF4, or NaF) and crystal structure (cubic vs hexagonal NaRF4) to be precipitated. Consequently, this study shows that MD simulations with effective potentials can fill the gap in the structural understanding of oxyfluoride glass and provide insights into atomic scale information of the phase separation behavior that is useful in predicting the potential crystal types in oxyfluoride glass. When coupled with experimental validations, these simulations can expedite the exploration of novel luminescent oxyfluoride glass ceramics.

A Lipopeptide-Based αvß3 Integrin-Targeted Ultrasound Contrast Agent for Molecular Imaging of Tumor Angiogenesis.

The design and fabrication of targeted ultrasound contrast agents are key factors in the success of ultrasound molecular imaging applications. Here, we introduce a transformable αvß3 integrin-targeted microbubble (MB) by incorporation of iRGD-lipopeptides into the MB membrane for non-invasive ultrasound imaging of tumor angiogenesis. First, the iRGD-lipopeptides were synthesized by conjugating iRGD peptides to distearoylphosphatidylethanolamine-polyethylene glycol 2000-maleimide. The resulting iRGD-lipopeptides were used for fabrication of the iRGD-carrying αvß3 integrin-targeted MBs (iRGD-MBs). The binding specificity of iRGD-MBs for endothelial cells was found to be significantly stronger than that of control MBs (p < 0.01) under in vitro static and dynamic conditions. The binding of iRGD-MBs on the endothelial cells was competed off by pre-incubation with the anti-αv or anti-ß3 antibody (p < 0.01). Ultrasound images taken of mice bearing 4T1 breast tumors after intravenous injections of iRGD-MBs or control MBs revealed strong contrast enhancement within the tumors from iRGD-MBs but not from the control MBs; the mean acoustic signal intensity was 10.71 ± 2.75 intensity units for iRGD-MBs versus 1.13 ± 0.18 intensity units for the control MBs (p < 0.01). The presence of αvß3 integrin was confirmed by immunofluorescence staining. These data indicate that iRGD-MBs can be used as an ultrasound imaging probe for the non-invasive molecular imaging of tumor angiogenesis, and may have further implications for ultrasound image-guided tumor targeting drug delivery.