PI3Kδ inhibition alleviates the brain injury during cerebral ischemia reperfusion via suppressing pericyte contraction in a TNF-α dependent manner.

The pericytes (PCs) surrounding capillaries are vital regulators of capillary constriction. Persistent PC contraction results in the increased capillary constriction, therefore leading to the impaired cerebral blood flow (CBF) recovery after reperfusion and worsening the clinical outcomes in stroke patients. However, the potential determinants of PC functions during ischemia/reperfusion are poorly understood. Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit Delta (PIK3CD/PI3Kδ) is a crucial factor involved with neuronflammation during ischemic stroke. PI3Kδ has shown the expression in PCs, while its effect on PC functions has not been explored yet. In this study, a rodent ischemia/reperfusion model was established in C57BL/6 mice via transient middle cerebral artery occlusion and reperfusion (MCAO/R). The PI3Kδ expression in ischemic penumbra was remarkably upregulated following MCAO/R induction. PI3Kδ inhibitor CAL-101 improved the CBF recovery, ischemic brain injury, and suppressed capillary constriction in MCAO/R mice. Besides, the production of tumor necrosis factor alpha (TNF-α), an inducer for tissue injury, and the expression of transient receptor potential vanilloid type 2 (TRPV2), a channel protein permitting calcium (Ca2+) uptake, were significantly reduced in ischemic penumbra after CAL-101 treatment. In vitro, oxygen-glucose deprivation and reoxygenation (OGD/R) enhanced the expression of PI3Kδ and TRPV2 in primary mouse PCs. CAL-101 suppressed the TNF-α-induced TRPV2 expression in OGD/R-treated PCs, thus inhibiting the Ca2+ uptake and PC contraction. Collectively, this study suggests that PI3Kδ is a critical regulator of PC function during ischemic stroke.

Development of on-DNA Formation of Benzofuran for DNA-Encoded Library Synthesis.

Using a novel homologation-heterocyclization cascade, the on-DNA synthesis of benzofurans from aldehydes has been developed. The methodology, based on an innovative use of the Seyferth-Gilbert homologation, followed by a high yielding Sonogashira coupling in situ intramolecular cyclization one-pot, two-step reaction, provides a powerful and unique pathway for DNA-encoded library (DEL) synthesis of a wide array of pharmaceutically relevant benzofuran-based scaffolds.

Boesenbergia rotunda displayed anti-inflammatory, antioxidant and anti-apoptotic efficacy in doxorubicin-induced cardiotoxicity in rats.

This study evaluated the cardioprotective properties of Boesenbergia rotunda extract (BrE) against doxorubicin (DOX) induced cardiotoxicity. Rats received oral gavage of BrE for 28 days and DOX (5 mg/kg/week for 3 weeks). Thereafter the animals were sacrificed, blood and cardiac samples were collected for biochemical, histological and immunohistochemical analyses. The results indicated that BrE attenuated DOX triggered body and cardiac weight loss and prevented against cardiac injury by mitigating histopathological alterations in cardiac tissues as well as serum cardiac function enzymes. BrE significantly reduced serum levels of aspartate transaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), troponin T (TnT) and creatine kinase-MB (CK-MB) in DOX-treated rats. Furthermore, BrE alleviated cardiotoxicity by reducing DOX instigated oxidative stress and potentiating the level of glutathione, as well as the activities superoxide dismutase and catalase in cardiac tissues. In addition, BrE significantly decreased the characteristic indices of DOX-induced cardiac inflammation and apoptosis. Immuno-histochemical analysis revealed that BrE decreased the stain intensity of p53 and myeloperoxidase (MPO) proteins compared to the DXB alone group. In conclusion, our results indicated that BrE modulated oxidative stress, inflammation and apoptosis to attenuate DOX-induced cardiac damage.

Study on the real-time variation laws and mechanism of oil sample viscosity during ultrasonic irradiation.

It is rather significant to reveal the real-time variation of oil sample viscosity during ultrasonic irradiation to research the mechanism of viscosity change. In this paper, we first simulate the acoustic field distribution law in the reaction chamber by using the finite element method and orthogonal experiment method, then measure the viscosity of the oil sample with temperature by vibration type viscometer and get the corresponding function equation by fitting. On this basis, we measure the viscosity of the oil sample with ultrasonic irradiation time and electric power change in real-time and in situ, and finally analyze the mechanism of oil sample viscosity variation by using a temperature recorder and cavitation noise method. The results show that the greatest influence on the acoustic pressure in the reaction chamber is the change of the transducer probe in the height Z direction, followed by the width X direction and the depth Y direction. The viscosity of the oil sample shows an exponential decay with the increase in temperature. With the increase of ultrasonic irradiation time and electric power, the viscosity of the oil sample is gradually reduced. By comparing the effect of heating and ultrasonic irradiation on viscosity, it is found that ultrasonic irradiation not only changes the viscosity through thermal effect but also the cavitation noise analysis and the phenomena observed in the experiment confirm that the cavitation effect and mechanical effect exist all the time.

Development of On-DNA Thiophene Synthesis for DEL Construction.

Thiophene and its substituted derivatives are a highly important class of heterocyclic compounds, with noteworthy applications in pharmaceutical ingredients. In this study, we leverage the unique reactivity of alkynes to generate thiophenes on-DNA, using a cascade iodination, Cadiot-Chodkiewicz coupling and heterocyclization. This approach, tackling on-DNA thiophene synthesis for the first time, generates diverse, and unprecedented structural and chemical features, which could be significant motifs in DEL screening as molecular recognition agents for drug discovery.

Component wave calculation and analysis of the acoustic field in a borehole within a three-phase porous medium.

The knowledge of acoustic wave propagation in a borehole embedded in gas hydrate-bearing sediments is of great significance for the exploitation of gas hydrate. A gas hydrate-bearing sediment is a typical three-phase porous medium containing two solids and one fluid. However, until now, the borehole acoustic wavefield and its component waves within such a porous medium have never been calculated. In this work, a real-axis integration method is proposed to calculate the borehole acoustic field embedded in a three-phase porous medium based on the Biot-type three-phase theory. Meanwhile, a component wave approach, combined with the branch-cut integral method and the residue theorem, including residues at leaky poles is proposed to study the borehole wave propagation of a three-phase porous medium. The branch points and poles of the potential acoustic wave function are obtained, which correspond to the normal and leaky modes on various Riemann sheets. On this basis, the excitation intensity and waveforms of each component are obtained. The result shows that the waveform summed up from all individual waves agrees well with the full waveform calculated by real-axis integration, which provides a theoretical basis for the subsequent inversion of reservoir parameters by using the information of various mode waves.

A comparative study of the efficacy of intra-articular injection of different drugs in the treatment of mild to moderate knee osteoarthritis: A network meta-analysis.

BACKGROUND: Knee osteoarthritis (KOA) has a high clinical prevalence and frequently interferes with patients normal lives. In KOA patients, evidence suggests that intra-articular (IA) injection improves joint function and decreases discomfort. Several IA injection treatments are used in daily practice to improve symptomatic control of knee osteoarthritis, but their efficacy is frequently disputed. METHODS: This network meta-analysis compares the efficacy of different IA injections for mild to moderate knee osteoarthritis. Seven databases (PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine disc, WanFang, and China National Knowledge Infrastructure) were searched for randomized controlled trials published up to and including December 20, 2021, and final follow up indicators were used. Visual analogue scale (VAS) score and The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (WOMAC) score change from baseline were the primary outcomes. We used the Cochrane risk of bias tool to assess the quality and risks of biases of papers. We calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for each outcome. State (Version 15.1, Texas, USA) and SPSS (Version 20, Chicago, USA) was used in all statistical analyses, and Review Manager (version 5.4) was used in assessing the risks of biases. RESULTS: Our study included 16 randomized controlled trials with a total of 1652 patients. platelet-rich plasma (PRP) IA injection therapy had the highest likelihood of being the best intervention in reducing WOMAC pain (surface under the cumulative ranking area [SUCRA] 84.7%), stiffness (SUCRA 95.1%), and function (SUCRA 98.5%) scores, according to the SUCRA. The best measures for lowering the WOMAC total and VAS scores were IA injection platelet-rich plasma-derived growth factor (SUCRA 84.9%) and hyaluronic acid and platelet-rich plasma (SUCRA 84.9%). In the VAS score group, PRP outperformed hyaluronic acid (HA) (WMD 1.3, 95% CI 0.55-2.55) and corticosteroids (CS) (WMD 4.85, 95% CI 4.02-5.08), according to the forest map results. PRP also outperformed CS (WMD 14.76, 95% CI 12.11-17.41), ozone (WMD 9.16, 95% CI 6.89-11.43), and PRP + HA (WMD 2.18, 95% CI 0.55-3.81) in the WOMAC total score group. Furthermore, PRP outperforms other drugs in terms of reducing WOMAC function, stiffness, and function score. CONCLUSION: In patients with mild to moderate KOA, IA injection PRP outperformed IA injection ozone, HA, CS, platelet-rich plasma-derived growth factor, and hyaluronic acid and platelet-rich plasma in terms of pain, stiffness, and dysfunction.

Assessment of ultrasound shear wave elastography: An animal ex-vivo study.

OBJECTIVES: To explore the influence of the surrounding environment of the target tissue, lesion size, and rectangular sampling box size on shear wave speed (SWS). METHODS: The tendon SWS was acquired ex-vivo. Then the tendons were dissected and buried in the couplant (gel) and evaluated by two-dimensional shear wave elastography (2D-SWE). Finally, the tendons were placed in the isolated muscles to simulate the intramuscular lesions, and their elasticity was tested under two rectangular sampling box conditions. The isolated complete liver SWS was acquired. Similarly, the large and small pieces of livers were cut out, placed in the muscles, and assessed by SWE under two rectangular sampling box conditions. The SWS acquired under different conditions was compared. Variability was evaluated using the coefficient of variation (CV). The intraclass correlation coefficient (ICC) was used to evaluate repeatability. RESULTS: The SWS of the tendons ex-vivo, buried in the couplant and placed in the isolated muscles showed significant differences (p < 0.001). The ex-vivo condition produced the highest SWS and CV values. There were significant differences in SWS of livers with different sizes placed in muscles (p < 0.001). The highest SWS value was associated with small pieces of livers. No significant difference was found in SWS acquired under different rectangular box sizes (p > 0.05). CONCLUSIONS: Under the present study conditions, the surrounding environment of the target tissue makes a big difference to lesion SWS values. The lesion size will affect the assessment of its inherent elasticity. The size of the sampling frame has no significant effect on the tissue SWS.

The effect of Xuezhikang capsule on gene expression profile in brown adipose tissue of obese spontaneously hypertensive rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Obesity is a critical threat to global health, and brown adipose tissue (BAT) is a potential target for the treatment of obesity and comorbidities. Xuezhikang Capsule (XZK), an extract of red yeast rice, has remarkable clinical efficacy and is widely used for the treatment of hyperlipidemia and coronary heart disease. However, its modulatory effect on BAT remains unknown. AIM OF THIS STUDY: The aim of this study was to investigate the protective mechanism of XZK in the obese spontaneously hypertensive rat (SHR) model by evaluating the regulatory effect of XZK on the BAT gene profile through transcriptome sequencing. MATERIALS AND METHODS: The SHRs were randomly divided into four groups: the standard chow diet (STD) group, the STD supplemented with 126 mg/kg of XZK group, the high-fat diet (HFD) group, and the HFD supplemented with 126 mg/kg of XZK group. All SHRs were fed for 18 weeks. The metabolic phenotypes, including body weight, fat mass, oral glucose tolerance test (OGTT), and serum glucose and lipid levels, was evaluated, and hematoxylin and eosin staining (H&E) staining was performed to evaluate the adipose tissue histopathological phenotype. Transcriptome sequencing was performed to determine the mechanism by which XZK improves the metabolic phenotype and the expression of key differential expression genes was verified by real-time quantitative polymerase chain reaction (qRT-PCR). RESULTS: XZK inhibited HFD-induced weight gain and adipose tissue remodeling in SHRs and prevented hypertrophy of epididymal adipocytes and maintained the brown fat phenotype. XZK intervention also improved glucose and lipid metabolism in SHRs, as suggested by a reduction in serum triglyceride (TG), low-density cholesterol (LDL-C), and fasting blood glucose (FBG) levels as well as increasing in serum high-density cholesterol (HDL-C) levels. Transcriptome sequencing analysis confirmed the regulatory effect of XZK on the gene expression profile of BAT, and the expression patterns of 45 genes were reversed by the XZK intervention. Additionally, the results of the transcriptome analysis of 10 genes that are important for brown fat function were in line with the results of qRT-PCR. CONCLUSIONS: XZK protected SHRs from HFD-induced obesity, inhibited fat accumulation and improved glucolipid metabolism. Additionally, the protective effect of XZK on the overall metabolism of obese SHRs might partly be related to its regulatory effect on the BAT gene expression profile. These findings might provide novel therapeutic strategies for obesity-related metabolic diseases in traditional Chinese medicine (TCM).

Diagnosis of patients with mucopolysaccharidosis type II via RNA sequencing.

BACKGROUND: Mucopolysaccharidosis type II (MPS II) is an X-linked recessive lysosomal storage disorder caused by various variants in the IDS gene. It is known that genomic recombinants between IDS and its homologous pseudogene IDSP1 account for a small number of patients, for whom genetic diagnosis usually relies on restriction enzyme digestion at specific loci. Nevertheless, such approach cannot reveal the impact of rearrangements on IDS transcription, which is crucial for the interpretation of the pathogenicity of rearrangement variants. METHODS: RNA sequencing (RNA-seq) was explored to analyze transcriptional alterations in four male MPS II patients who were negative for Sanger sequencing of the IDS gene. Reverse transcription-polymerase chain reaction and TA clone sequencing were used to validate RNA-seq analysis results. The IDS-IDSP1 recombinant was determined by sequencing the indicated loci in genome. RESULTS: Differential expression analysis showed the expression levels of IDS gene in patients were largely reduced compared to the healthy individuals. Differential splicing analysis revealed skipping of exons 8 and 9 of IDS, without any splice-junction defects at the genomic level. In addition, two types of fusion transcripts, IDS_EOLA1 and IDS_EOLA1-DT_EOLA1 were identified by gene fusion analysis. Sequencing of the known rearrangement alleles showed these four patients have the same type of IDS-IDSP1 recombinant. CONCLUSION: We establish an RNA-seq workflow to analyze transcriptional characteristics of IDS gene from multiple perspectives. Our study validates the diagnostic value of RNA-seq in MPS II, including the discovery of transcriptional alterations and the potential to suggest genome-level rearrangements in IDS.

Kinugasa Reaction for DNA-Encoded ß-Lactam Library Synthesis.

ß-Lactam antibiotics are one of the most important antibacterial drug classes worldwide. This work will present the first prototype on-DNA ß-lactam combinatorial library with novel structures and chemical space properties that would be significant for phenotypic screening to identify the next generation of antibiotics to combat the pervasive problem of bacterial resistance.

Is vitamin D deficiency a risk factor for all-cause mortality and rehospitalization in heart failure patients?: A systematic review and meta-analysis.

OBJECTIVE: The association of low 25-hydroxyvitamin D level with mortality and rehospitalization remains inconsistent in patients with heart failure. This systematic review and meta-analysis aimed to evaluate the value of blood 25-hydroxyvitamin D level in predicting all-cause mortality and hospitalization in heart failure patients. METHODS: Two reviewers independently search the articles indexed in PubMed and Embase databases until November 30, 2021. Only the prospective or retrospective cohort studies evaluating the association of blood 25-hydroxyvitamin D level with all-cause mortality and rehospitalization in heart failure patients were selected. The predictive value of 25-hydroxyvitamin D level was summarized by pooling multivariable adjusted risk estimates for the bottom versus reference top 25-hydroxyvitamin D level. RESULTS: Seven studies with a total of 5941 patients with heart failure were identified. The pooled adjusted risk ratio (RR) of all-cause mortality was 1.37 (95% confidence interval [CI] 1.13-1.66), with significant heterogeneity (I2 = 70.5%; P = 0.002). However, there was no clear association between low 25-hydroxyvitamin D level and all-cause rehospitalization risk (RR 1.38; 95% CI 0.87-2.19). CONCLUSIONS: Low blood level of 25-hydroxyvitamin D may be an independent risk factor for all-cause mortality in patients with heart failure. Serum 25-hydroxyvitamin D level may provide prognostic information in heart failure patients. Additional randomized controlled trials are required to explore whether treatment of 25-hydroxyvitamin D deficiency by supplementation of vitamin D can improve survival in heart failure patients.

Assessment of ultrasound shear wave elastography within muscles using different region of interest sizes, manufacturers, probes and acquisition angles: an ex vivo study.

Background: The application of shear wave elastography (SWE) in assessment of the musculoskeletal system is affected by various factors. This study aimed to explore the influence of machines, probes, region of interest (ROI) sizes, and the acquisition angles on muscle shear wave speed (SWS). Methods: The SWS of ex vivo isolated muscles were acquired using 3 different machines (Aixplorer system, SuperSonic Imagine; Acuson S3000, Siemens Healthcare; Resona 7, Mindray) and 2 linear probes (Aixplorer system, SL 10-2 and SL 15-4). Also, 4 different ROI sizes (diameter 1-10 mm) and 9 different acquisition angles (0-40°) were tested. The SWS acquired under different conditions were compared, and the intra-class correlation coefficients (ICC) were used to evaluate reproducibility. Results: There was a significant difference in SWS acquired using the 3 different machines (P<0.001) or with 9 different angles (P=0.008). There was no significant difference in SWS acquired using 2 probes (P=0.053) or 4 different ROI sizes (P=0.874, 0.778, and 0.865 for 3 operators, respectively). All machines produced substantial intra-system reproducibility (ICC, 0.61-0.80). Both probes demonstrated an almost perfect degree of intra-system agreement (ICC, >0.80), and nearly all ROI sizes demonstrated an almost perfect degree of intra- and inter-operator agreement (ICC, >0.80). The measurement reliability was higher when the acquisition angles were no more than 20°. Conclusions: The 3 machines had different SWS values. Attention should be paid when comparing SWS results using different machines. For the Aixplorer system, the ROI size had no effect on the SWS values. Angles larger than 25° will lead to SWS measurements with greater variability compared to smaller angles (≤20°).

Risk Factors Associated With Social Media Addiction: An Exploratory Study.

The use of social media is becoming a necessary daily activity in today's society. Excessive and compulsive use of social media may lead to social media addiction (SMA). The main aim of this study was to investigate whether demographic factors (including age and gender), impulsivity, self-esteem, emotions, and attentional bias were risk factors associated with SMA. The study was conducted in a non-clinical sample of college students (N = 520), ranging in age from 16 to 23 years, including 277 females (53%) and 243 males (47%). All participants completed a survey measuring impulsivity, self-esteem, anxiety, depression, social anxiety, loneliness, and attentional bias. The final hierarchical regression model indicated significant risk factors for SMA with an accuracy of 38%. The identified set of associated risk factors included female gender (ß = -0.21, t = -4.88, p < 0.001), impulsivity (ß = 0.34, t = 8.50, p < 0.001), self-esteem (ß = -0.20, t = -4.38, p < 0.001), anxiety (ß = 0.24, t = 4.43, p < 0.001), social anxiety (ß = 0.25, t = 5.79, p < 0.001), and negative attentional biases (ß = 0.31, t = 8.01, p < 0.001). Finally, a discussion of the results is presented, followed by corresponding recommendations for future studies.

Acoustic characterization of cavitation intensity: A review.

Cavitation intensity is used to describe the activity of cavitation, and several methods are developed to identify the intensity of cavitation. This work aimed to provide an overview and discussion of the several existing characterization methods for cavitation intensity, three acoustic approaches for charactering cavitation were discussed in detail. It was showed that cavitation noise spectrum is too complex and there are some differences and disputes on the characterization of cavitation intensity by cavitation noise. In this review, we recommended a total cavitation noise intensity estimated via the integration of real cavitation noise spectrum over full frequency domain instead of artificially adding inaccurate filtering processing.

The mechanism of ultrasonic irradiation effect on viscosity variations of heavy crude oil.

Viscosity reduction of heavy oil has economic benefits and applicational value in the field. Applying viscosity reduction technology of heavy oil with ultrasound, this paper examines the influence of ultrasonic irradiation time and the addition of tetralin and ethylene glycol on viscosity reduction of heavy oil. Fourier Transform Infrared Spectrometer (FTIR) and Gas Chromatograph (GC) were used to analyze the chemical compositions and structural changes of oil samples before and after ultrasonic irradiation, and the effects of ultrasound on viscosity changes are presented. The viscosity reduction rate (VRR) was best at an irradiation time of 6 mins under the current experimental conditions, with VRR reaching more than 80%. When the irradiation time reached 12 mins, the viscosity of oil samples increased conversely. Chemical analysis reveals that the light components in the oil samples increased after the ultrasonic irradiation, indicating that the cavitation, thermal, and mechanical effects of ultrasound could play a role in breaking long chains of carbon, thus reducing the viscosity. The increase in viscosity may have been caused by a reassociation between molecules and/or the coking of heavy oil.

Differential diagnosis between small breast phyllodes tumors and fibroadenomas using artificial intelligence and ultrasound data.

BACKGROUND: It is challenging to differentiate between phyllodes tumors (PTs) and fibroadenomas (FAs). Artificial intelligence (AI) can provide quantitative information regarding the morphology and textural features of lesions. This study attempted to use AI to evaluate the ultrasonic images of PTs and FAs and to explore the diagnostic performance of AI features in the differential diagnosis of PTs and FAs. METHODS: A total of 40 PTs and 290 FAs <5 cm in maximum diameter found in female patients were retrospectively analyzed. All tumors were segmented by doctors, and the features of the lesions were collated, including circularity, height-to-width ratio, margin spicules, margin coarseness (MC), margin indistinctness, margin lobulation (ML), internal calcification, angle between the long axis of the lesion and skin, energy, grey entropy, and grey mean. The differences between PTs and FAs were analyzed, and the diagnostic performance of AI features in the differential diagnosis of PTs and FAs was evaluated. RESULTS: Statistically significant differences (P<0.05) were found in the height-to-width ratio, ML, energy, and grey entropy between the PTs and FAs. Receiver operating characteristic (ROC) curve analysis of single features showed that the area under the curve [(AUC) 0.759] of grey entropy was the largest among the four features with statistically significant differences, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 0.925, 0.459, 0.978, and 0.190, respectively. When considering the combinations of the features, the combination of height-to-width ratio, margin indistinctness, ML, energy, grey entropy, and internal calcification was the most optimal of the combinations of features with an AUC of 0.868, and a sensitivity, specificity, PPV, and NPV of 0.734, 0.900, 0.982, and 0.316, respectively. CONCLUSIONS: Quantitative analysis of AI can identify subtle differences in the morphology and textural features between small PTs and FAs. Comprehensive consideration of multiple features is important for the differential diagnosis of PTs and FAs.

CNV profiles of Chinese pediatric patients with developmental disorders.

PURPOSE: To examine the overall genomic copy-number variant (CNV) landscape of Chinese pediatric patients with developmental disorders. METHODS: De-identified chromosomal microarray (CMA) data from 10,026 pediatric patients with developmental disorders were collected for re-evaluating the pathogenic CNV (pCNV) yields of different medical conditions and for comparing the frequency and phenotypic variability of genomic disorders between the Chinese and Western patient populations. RESULTS: The overall yield of pCNVs in the Chinese pediatric patient cohort was 21.37%, with variable yields for different disorders. Yields of pCNVs were positively associated with phenotypic complexity and intellectual disability/developmental delay (ID/DD) comorbidity for most disorders. The genomic burden and pCNV yield in neurodevelopmental disorders supported a female protective effect. However, the stratification analysis revealed that it was seen only in nonsyndromic ID/DD, not in nonsyndromic autism spectrum disorders or seizure. Furthermore, 15 known genomic disorders showed significantly different frequencies in Chinese and Western patient cohorts, and profiles of referred clinical features for 15 known genomic disorders were also significantly different in the two cohorts. CONCLUSION: We defined the pCNV yields and profiles of the Chinese pediatric patients with different medical conditions and uncovered differences in the frequency and phenotypic diversity of genomic disorders between Chinese and Western patients.

Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A.

BACKGROUND: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions. METHODS: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed. RESULTS: Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P = 0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions. CONCLUSIONS: Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.

Effect of acquisition depth and precompression from probe and couplant on shear wave elastography in soft tissue: an in vitro and in vivo study.

BACKGROUND: Shear wave elastography is a promising method to diagnose early musculoskeletal lesions. We aimed to explore the feasible depth and acceptable precompression applied by probe and couplant for soft tissues in the present system. METHODS: Ex-vivo muscles were evaluated at depths of 0.5-6 cm by 3 operators, using 1-5 mm couplant thickness and 0-3.0 kPa probe pressure. We compared the shear wave speed (SWS) and used intraclass correlation coefficients to assess reproducibility. In vivo skin and subcutaneous superficial fascia from volunteers were tested at depths ranging from 0.1-0.5 cm with 1-20 mm couplant thickness. RESULTS: The SWS of ex-vivo muscles varied and increased with depth, and could not be acquired at 6 cm because the shear wave failed to be detected. Furthermore, while the SWS of ex-vivo muscles were not affected by the couplant thickness, it was affected by probe pressure. Most cases demonstrated a satisfactory agreement degree of the intraoperator reproducibility (ICC, 0.81-0.95) and a substantial interoperator reproducibility (ICC >0.60). Inter- and intra-operator reproducibility was better at a depth of 0.5-4 cm than at 5 cm. In the in vivo study, when tissues within a 0.2 cm depth were evaluated, the SWS that was acquired using a couplant thickness of >10 mm was different from that acquired using other thicknesses. CONCLUSIONS: The SWS acquired at a depth of ≤3 cm with a suitable amount of couplant is recommended.