Low-temperature lithium-ion batteries: challenges and progress of surface/interface modifications for advanced performance.

Lithium-ion batteries are in increasing demand for operation under extreme temperature conditions due to the continuous expansion of their applications. A significant loss in energy and power densities at low temperatures is still one of the main obstacles limiting the operation of lithium-ion batteries at sub-zero temperatures. In addition to electrodes and electrolytes, more attention should be paid to the electrode-electrolyte interface, considering that the total internal resistance of batteries at low temperatures is dominated by interfacial charge transfer resistance. Here, we first review the main interfacial processes in lithium-ion batteries at low temperatures, including Li+ solvation or desolvation, Li+ diffusion through the solid electrolyte interphase and electron transport. Then, recent progress on the electrode surface/interface modifications in lithium-ion batteries for enhanced low-temperature performance is presented in detail. The lasting challenges and perspectives regarding electrode/electrolyte interface control in low-temperature lithium-ion batteries are finally discussed.

Quantitative evaluation of right atrial function in fetuses with moderate to severe tricuspid regurgitation by two-dimensional speckle tracking echocardiography / 中华超声影像学杂志

Objective:To explore the application value of two-dimensional speckle tracking echocardiography (2D-STE) in measuring the global longitudinal peak strain of the right atrium (PRAGLS) in normal fetuses and evaluating PRAGLS in assessing right atrial function in fetuses with moderate and severe tricuspid regurgitation (TR).Methods:A total of 25 fetuses diagnosed with moderate and severe TR, who underwent fetal echocardiography at Run Run Shaw Hospital, Zhejiang University College of Medicine between October 2020 and May 2022, were selected as the case group. Their gestational age ranged from 25.00(24.00, 30.00)weeks. Additionally, 100 normal singleton fetuses were chosen as the control group, with a gestational age of 25.83(23.00, 28.75)weeks. Standard basal or apical four-chamber clips were acquired and inputted into TOMTEC-ARENA offline cardiac analysis software for analysis. The fetal PRAGLS values of the two groups were obtained, as well as the routine obstetric ultrasound measurements and fetal echocardiographic parameters of both groups: fetal heart rate (FHR), biparietal diameter (BPD), femur length (FL), aortic annulus inner diameter (AO), pulmonary annulus inner diameter (PA), PA/AO ratio, right atrial end-systolic length (RAESL), right atrial end-systolic diameter (RAESD), right atrial end-systolic area (RAESA), right ventricular end-diastolic diameter (RVEDD), and tricuspid annular plane systolic excursion (TAPSE). The peak TR velocity and pressure gradient were simultaneously measured in the case group.The differences in fetal PRAGLS and other parameters between the two groups were compared and analyzed. The correlation between fetal PRAGLS and gestational age (GA) and routine measurements was assessed for both groups. Intra- and inter-observer repeatability tests were conducted using the intragroup correlation coefficient (ICC).Results:A significant difference in PRAGLS was observed between the two groups ( t=11.55, P<0.01). The TAPSE difference between the two groups was also statistically significant ( Z=3.45, P=0.01). Notable differences were found in AO, PA, PA/AO, RAESL, RAESD, and RAESA between the two groups (all P<0.05), but no significant differences were identified in age, GA, FHR, BPD, FL, and RVEDD between the two groups (all P>0.05). PRAGLS in the control group exhibited a moderate negative correlation with GA ( r=-0.47, P<0.01) and were correlated with BPD, FL, AO, PA, RAESL, RAESD, RAESA, and RVEDD ( r=-0.50, -0.46, -0.39, -0.43, -0.45, -0.36, -0.43, -0.32, all P<0.05). No significant correlation was observed with maternal age, FHR, PA/AO, and TAPSE (all P>0.05). No significant correlation between PRAGLS and GA or other conventional parameters was found in the case group (all P>0.05). The inter-measurer and intra-measurer ICC of PRAGLS in the control group were 0.87 and 0.79, respectively, while the inter-measurer and intra-measurer ICC of PRAGLS in the case group were 0.94 and 0.97, respectively, demonstrating good consistency. Conclusions:2D-STE exhibits strong feasibility and reproducibility in assessing fetal atrial function.Fetuses with moderate and severe TR display decreased PRAGLS, suggesting impaired right atrial reservoir function. Right atrial strain introduces a novel method for evaluating fetal cardiac function.

Preliminary study on thyroid ultrasound image restoration algorithm based on deep learning / 中华超声影像学杂志

Objective:To explore the feasibility of deep learning-based restoration of obscured thyroid ultrasound images.Methods:A total of 358 images of thyroid nodules were retropectively collected from January 2020 to October 2021 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and the images were randomly masked and restored using DeepFillv2. The difference in grey values between the images before and after restoration was compared, and 6 sonographers (2 chief physicians, 2 attending physicians, 2 residents) were invited to compare the rate of correctness of judgement and detection of image discrepancies. The ultrasound features of thyroid nodules (solid composition, microcalcifications, markedly hypoechoic, ill-defined or irregular margins, or extrathyroidal extensions, vertical orientation and comet-tail artifact) were extracted according to the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). The consistency of ultrasound features of thyroid nodules before and after restoration were compared.Results:The mean squared error of the images before and after restoration ranged from 0.274 to 0.522, and there were significant differences in the rate of correctness of judgement and detection of image discrepancies between physicians of different groups(all P<0.001). The overall accuracy rate was 51.95%, the overall detection rate was 1.79%, there were significant differences also within the chief physicians and resident groups (all P<0.001). The agreement rate of all ultrasound features of the nodules before and after image restoration was higher than 70%, over 90% agreement rate for features such as solid composition and comet-tail artifact. Conclusions:The algorithm can effectively repair obscured thyroid ultrasound images while preserving image features, which is expected to expand the deep learning image database, and promote the development of deep learning in the field of ultrasound images.

Preliminary study of cardiac morphology and function in fetuses with tetralogy of Fallot using fetal heart quantification / 中华超声影像学杂志

Objective:To evaluate the fetal heart shape and function in tetralogy of Fallot (TOF) by fetal heart quantitative analysis (fetal HQ).Methods:A total of 52 fetuses with TOF diagnosed by fetal echocardiography and 200 normal fetuses matched with their gestational weeks from March 2020 to March 2022 at Sir Run Run Shaw Hospital, Zhejiang University were retrospectively evaluated. The basic parameters of fetal cardiac blood vessels in the two groups were measured by fetal HQ technology and conventional M-mode ultrasound technology: aortic valve diameter(AV), pulmonary artery valve diameter(PV), main pulmonary artery diameter (MPA) and Z-score. The overall morphometric measurements including end-diastolic length diameter, transverse diameter, area, and global spherical index (GSI) of the fetal heart in the 4-chamber view(4CV), area and length of the right and left ventricles and their ratios. Measurements of left and right ventricular function included ejection fraction (EF), fraction area change rate (FAC), tricuspid annular plane systolic excursion (TAPSE), left and right ventricular global longitudinal strain (GLS), and left and right ventricular end-diastolic diameter (ED), spherical index (SI), and fractional shortening rate (FS) of 24-segments. The differences of above parameters between TOF group and control group were compared. In addition, the relationships between the absolute value of left and right ventricular GLS of TOF fetus and PV/AV, PV Z-score and MPA Z-score were analyzed. The optimal critical values of GSI, left ventricular EF and left ventricular FAC of TOF fetus were determined by ROC curve, and their corresponding sensitivity and specificity were obtained.Results:Compared with control group, there were significant differences in 4CV end-diastolic length, area, GSI, left ventricular area, left ventricular length, left ventricular EF, left ventricular FAC and left ventricular GLS in TOF group (all P<0.05). There were significant differences in ED between left ventricular 15-24 segments and right ventricular 1-21 segments (all P<0.05). There were significant differences in SI between left ventricular 1-16 segments, 21-24 segments and all segments of right ventricle (all P<0.05). The differences in FS were statistically significant (all P<0.05) when comparing all segments of the left ventricle and 1-2 segments of the right ventricular, and the remaining parameters were not statistically significant (all P>0.05). The left ventricular GLS absolute value of TOF fetuses was positively correlated with PV/AV, PV Z-score and MPA Z-score( rs=0.338, 0.441 and 0.458, all P<0.05), the right ventricular GLS absolute value of TOF fetuses was positively correlated with PV AV, PV Z-score and MPA Z-score( rs=0.418, 0.368 and 0.338, all P<0.05). The optimal critical values of GSI, left ventricular EF, and left ventricular FAC in the diagnosis of fetal TOF were 1.19, 59.05%, and 44.4%, respectively. At this time, the sensitivities of diagnosis of TOF were 0.78, 0.75, and 0.80, respectively. The specificities were 0.88, 0.88 and 0.83, respectively. The areas under ROC curve were 0.89, 0.88 and 0.89, respectively. Conclusions:Fetal HQ technology can provide a simple and reliable quantitative evaluation of fetal heart shape and function, and provide certain theoretical parameters for the study of fetal heart shape and function.

The strategy of removing tracheal stents by using an interventional technique under fluoroscopy.

BACKGROUND: Tracheal stent implantation is widely used in clinic settings. Timely removal of tracheal stents could prevent or reduce related complications. This study was aimed at evaluating the feasibility and safety of removing tracheal stents by an interventional technique under fluoroscopy. METHODS: Clinical data of patients with self-expanding uncovered tracheal stents removed by an interventional technique under fluoroscopy were analyzed retrospectively, including medical records, imaging findings, surgical records, and follow-up results. According to the type and time of stent placement and the proliferation of granulation tissue under bronchoscopy, different tracheal stent removal techniques were used to remove the tracheal stent under fluoroscopy, and the feasibility and safety of the interventions were analyzed. RESULTS: In all, 148 tracheal stents were removed from 112 patients; 95.9% (142/148) of the stents were completely removed and 4.1% (6/148) had a small amount of metal residue, and foreign-body forceps were removed under fiber bronchoscopy guidance. In 78 (69.6%), 32 (21.6%), and 6 (5.4%) patients, the tracheal stent was removed by the internal stripping, direct removal, and stent-in-stent methods, respectively. The overall stent removal time ranged from 11 to 111 (28.9 ± 20.1) min. During stent removal, 16 (14.3%) and 13 (11.6%) patients developed mild and moderate complications, respectively. There were no serious complications such as massive hemorrhage, mediastinal fistula, or death. CONCLUSIONS: An interventional technique under fluoroscopy for stent removal is a feasible, safe, and effective method and could serve as a technique for tracheal stent removal in clinical settings.

Investigation of fetal cardiac size, morphology and function in fetuses with right ventricular outflow obstruction using fetal heart quantification / 中华超声影像学杂志

Objective:To investigate the application value of fetal heart quantification (fetal HQ) in the evaluation of fetal heart size, morphology and function in fetuses with right ventricular outflow obstruction (RVOTO).Methods:Fifty-five fetuses diagnosed as RVOTO by fetal echocardiography in Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University from April 2020 to February 2021 were selected. They were divided into simple pulmonary artery stenosis (PS) group and conus arteriosus malformation (CTD) group according to whether they were combined with other cardiovascular malformations. On the standard four chamber view, the end diastolic basal apical length (4CV length) and transverse width (4CV width) were obtained by fetal HQ analysis technique, and the cardiac global spherical index (4cv-gsi) was calculated. The left and right ventricles (LV and RV) were divided into 24 segments from the base to the apex. The endocardial curve was obtained by total HQ tracking. The 24 segment transverse width (ED), spherical index (SI), short axis shortening (FS) and its Z-score were calculated. The LV and RV of RVOTO fetuses were compared and analyzed from the aspects of heart size, morphology and function.Results:The 4CV length of RVOTO fetal heart was in the normal range, 4CV width increased in varying degrees, GSI decreased, and the whole heart showed spherical changes. In PS group, LV-ED was larger than that of RV and the difference was statistically significant in 5-24 segments( P<0.05). LV was more spherical than RV. There was no significant difference in ED between LV and RV in CTD group( P>0.05), and RV was more spherical than LV. Twenty-four segment FS decreased in different degrees in RVOTO fetal heart, and the decrease of RV was more obvious than that of LV. There was significant difference between the LV and RV in PS group from S5 to 19 ( P<0.05), and there was significant difference between the left and right ventricles in CTD group from S1 to 11 ( P<0.05). Conclusions:Fetal HQ can provide new insights of cardiac size, morphology and function in fetuses with RVOTO.

Application of fetal atrial septal excursion index and comprehensive Z-scores of cardiovascular structures in fetuses with redundancy foramen ovale flap / 中华超声影像学杂志

Objective:To investigate the application of fetal atria septal excursion index (ASEI) combining cardiovascular structure Z-scores in fetuses with redundancy foramen ovale flap (RFOF).Methods:Twenty-two fetuses with RFOF diagnosed by fetal echocardiography in Sir Run Run Shaw Hospital from December 2019 to September 2021 were selected as the RFOF group and 62 normal fetuses as the control group. The movement of the foramen ovale valve was observed in the four chamber view, and the maximum distance of the foramen ovale valve bulging, the total length of the atrial septum, the foramen ovale diameter, the diameters of the aortic valve, the pulmonary valve, the ascending aorta, the aortic isthmus, the descending aorta and the left and right ventricular areas were measured. ASEI, foramen ovale diameter, foramen ovale valve excursion distance, the ratio of foramen ovale diameter to total atrial septum length, aortic valvular annular diameter Z-score(AOV Z-score), pulmonary valvular annular diameter Z-score(PV Z-score), ascending aorta diameter Z-score(AOA Z-score), ascending aorta diameter Z-score (AOA Z-score), aortic isthmus Z-score (AOI Z-score), descending aorta diameter Z-score (AOD Z-score), diastolic right ventricular area Z-score (RV area Z-score) and diastolic left ventricular area Z-score(LV area Z-score) were compared between the two groups. RFOF fetuses were followed up to observe the prognosis.Results:There were significant differences in fetal ASEI, foramen ovale diameter, foramen ovale valve excursion distance, the ratio of foramen ovale diameter to total atrial septum length, AOV Z-score, PV Z-score, AOA Z-score, AOI Z-score, AOD Z-score and LV area Z-score between RFOF group and control group (all P<0.05), but there was no significant difference in RV area Z-score ( P>0.05). Postnatal follow-up outcomes in RFOF group indicated that 17 of 22 cases (77.3%) had live birth, five cases (22.7%) were lost at follow-up. Twelve of 17 live birth cases (70.5%) showed structurally normal heart by postnatal echocardiography, 3 cases (17.6%) showed mild coarctation of the aorta with nonsignificant hemodynamics under clinical follow-up, 2 cases (11.8%) were diagnosed with coarctation of the aorta, pulmonary artery dilation and atrial septal defect, and died after operation, of which one case died of infections pneumonia after operation. Another case was born prematurely at 36 + 4 weeks with a birth weight of 2 650 g, and neotal echocardiography showed ventricular septal defect, atrial septal defect and patent ductus arteriosus. Conclusions:ASEI can quantitatively evaluate the behavior of foramen ovale valve mobility and in combination with Z-scores of cardiovascular structures can be used to assess the morphological changes of fetal hearts. Although some fetuses with RFOF demonstrate left and right ventricular disproportion and coarctation of the aorta in fetal echocardiography, most fetuses have a good prognosis.

Effect of peroxiredoxin 3 level before delivery on birth weight of offspring in patients with gestational diabetes mellitus / 中国医师进修杂志

Objective:To explore the correlation between peroxiredoxin 3 (PRX3) level before delivery and birth weight of offspring in patients with gestational diabetes mellitus (GDM).Methods:The clinical data of 126 primiparous women with GDM in Beijing Changping District Hospital from December 2019 to December 2020 were retrospectively analyzed. According to the birth weight of offspring, the patients were divided into macrosomia (newborn birth weight ≥4 000 g) group (32 cases) and non-macrosomia group (94 cases). Patient general data were recorded, and PRX3 levels were measured at 12, 20, 28, 32, 36, 38 and 39 weeks of gestation. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of PRX3 for birth weight of offspring in patients with GDM.Results:There were no statistical difference in age, body mass index before pregnancy, white blood cell, hemoglobin, lymphocyte, platelet, and the incidences of gestational anemia, premature rupture, malposition, fetal distress, oligohydramnios, placenta praevia between 2 groups ( P>0.05). The PRX3 12, 20, 28, 32, 36, 38, 39 weeks of gestation and birth weight of offspring in macrosomia group were significantly higher than those in non-macrosomia group: (12.25 ± 2.36) μg/L vs. (10.11 ± 2.25) μg/L, (13.86 ± 2.33) μg/L vs. (11.95 ± 2.01) μg/L, (15.02 ± 2.58) μg/L vs. (12.69 ± 2.32) μg/L, (17.98 ± 3.69) μg/L vs. (14.79 ± 3.22) μg/L, (20.25 ± 2.94) μg/L vs. (16.55 ± 2.84) μg/L, (22.65 ± 3.88) μg/L vs. (18.06 ± 3.29) μg/L, (24.52 ± 3.59) μg/L vs. (19.57 ± 3.87) μg/L and (4 329.21 ± 300.58) g vs. (3 256.58 ± 330.47) g, and there were statistical differences ( P<0.01). According to the level of PRX3 before delivery, the patients with GDM were divided into high PRX3 group (71 cases, PRX3>20 μg/L) and low PRX3 group (55 cases, PRX3≤20 μg/L). The incidence of macrosomia in high PRX3 group was significantly higher than that in low PRX3 group: 30.99% (22/71) vs. 18.18% (10/55), and there was statistical difference ( P<0.05). Pearson correlation analysis result showed that the birth weight of offspring was positive correlation with PRX3 level in patients with GDM ( r = 0.226, P = 0.001). ROC curve analysis result showed that the area under curve of PRX3 in predicting birth weight of offspring in patients with GDM was 0.865, with a sensitivity of 86.2%, a specificity of 79.8%, Yoden index of 0.660, and the optimal cut-off of 19.35 μg/L. Conclusions:The level of PRX3 is positively correlated with birth weight of offspring in patients with GDM.

Mechanism and main active ingredients of Radix Et Rhizoma Tripterygii Wilfordii for breast cancer / 中国药理学通报

Aim To explore the main active ingredients of Tripterygium wilfordii and the mechanism in treat-ment of breast cancer based on network pharmacology.Methods The active components and targets of Tripterygii Wilfordii were searched by TCMSP.GeneCard database was used to screen the potential targets of Tripterygii Wilfordii in treatment of breast cancer.The two were matched to obtain the core components and targets of Tripterygii Wilfordii.Cytoscape3.6.0 and AutoDock Vina were used to draw the drug-target network diagram, and GO enrichment analysis, KEGG pathway enrichment analysis, and molecular docking between the core target and the components were carried out.CCK8 and qPCR were used to verify the effect of optimal core component tripterine on breast cancer cells.Results Seven kinds of active anti-breast cancer components and twenty-five core therapeutic targets of Tripterygii Wilfordii were obtained.Tripterine, which significantly inhibited the growth of breast cancer cells, was the most valuable component of Tripterygii Wilfordii for breast cancer.QPCR results showed that tripterine decreased the expression of core therapeutic targets.Conclusions The effectiveness of Tripterygii Wilfordii has multiple pathways, and tripterine may play an important role in treatment of breast cancer.

Study on establishing the reference range of atrial septal excursion index and foramen ovale membrane angle in normal fetuses aged 16-40 weeks / 中华超声影像学杂志

Objective:To establish the normal reference range of atrial septal excursion index (ASEI) and foramen ovale membrane angle in normal fetuses aged 16-40 weeks, and to analyze the correlation between ASEI and foramen ovale membrane angle in normal fetuses.Methods:A total of 378 normal singletons with gestational ages of 16-40 weeks undergoing by fetal echocardiography were selected in the Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, from January to June 2021, and 349 fetuses successfully finished all measurements. After all fetuses completed the systematic fetal echocardiography, fetal foramen ovale diameter and foramen ovale membrane angle were measured on the four chamber view. The maximum distance of foramen ovale valve from the base of atrial septum to the free wall of left atrium and the transverse diameter of left atrium were measured, and ASEI was calculated. The differences of ASEI, foramen ovale membrane angle and foramen ovale diameter of the groups with different gestational weeks were compared. The correlations among ASEI, foramen ovale membrane angle and foramen ovale diameter were analyzed by Pearson correlation analysis.Results:All 349 fetuses were divided into 6 groups according to their gestational weeks, including 17 cases at 16-20 weeks, 46 cases at 21-24 weeks, 114 cases at 25-28 weeks, 105 cases at 29-32 weeks, 31 cases at 33-36 weeks and 36 cases at 37-40 weeks. The ± s of ASEI was 0.492 7±0.059 7, 95% CI was 0.486 4-0.499 0, 95% normal reference value range was 0.375 7-0.609 8. Significant differences were found in ASEI among different groups( P<0.05). The ± s of foramen ovale membrane angle was (44.03±5.48)°, 95% CI was 43.46-44.61°, 95% normal reference value range was 33.29-54.78°. Significant differences were found in the foramen ovale membrane angle among different groups( P<0.05). The ± s of foramen ovale diameter was (4.32±1.30)mm, 95% CI was 4.18-4.45 mm, the differences among different groups were significant( P<0.05) and foramen ovale diameter was found increased with the increase of gestational weeks. There was a significant positive correlation between ASEI and foramen ovale membrane angle ( r=0.558, P<0.05). There was no correlation between foramen ovale diameter and ASEI and foramen ovale membrane angle ( r=-0.166, -0.084; all P>0.05). Conclusions:The normal reference ranges of ASEI and foramen ovale valve angle of normal fetuses aged 16-40 weeks was successfully established. These parameters may be useful for evaluating diastolic cardiac function by assessing foramen ovale.

Clinical Evaluation of Transarterial Infusion Chemotherapy for Advanced Esophageal Cancer.

Background: Most esophageal cancer patients are diagnosed at an advanced stage when there are few effective treatments. Transarterial infusion chemotherapy is a local chemotherapy method wherein chemotherapeutic drugs are directly injected into tumor vessels. Methods: Transarterial infusion chemotherapy was performed on advanced esophageal cancer patients once a month, and each patient underwent 1-3 treatments. The clinical results, complications, and effectiveness rates of each treatment episode were recorded and analyzed. Results: Transarterial infusion chemotherapy was successfully performed in all patients, and no severe complications such as paraplegia or death were noted. Complete response, partial response, and stable disease were noted in 17.3% (13/75), 77.3% (58/75), and 5.3% (4/75) of cases after transarterial infusion chemotherapy, respectively. The total treatment efficacy (complete response + partial response) was 94.7%. All cases exhibited improvement in clinical stage, with a marked decrease in dysphagia. Subsequent treatments were administered to 13 patients, including radical radiation in 7 and chemotherapy in 6. During follow-up, death was caused by progressive carcinoma in 20, tumor-related pneumatic infection and respiratory failure in 11, and gastrointestinal hemorrhage in 17. The median survival time was 15 months and the 1-year survival rate was 58.1%. Conclusions: Transarterial infusion chemotherapy may be safely and effectively used for treatment of advanced esophageal cancer.

Investigation of fetal cardiac function and morphology in fetuses with left ventricular outflow tract obstruction using fetal heart quantification / 中华超声影像学杂志

Objective:To explore the application value of fetal heart quantification (fetal HQ) in evaluation of fetal cardiac function and morphology in fetuses with left ventricular outflow tract obstruction (LVOTO).Methods:Twenty-five fetuses with LVOTO diagnosed by fetal echocardiography in Sir Run Run Shaw Hospital, Zhejiang University Medical College from April to July 2020 were enrolled. The end-diastolic basal apical length(BAL), transverse length (TL), global spherical index (GSI) of fetal four-chamber view, and the left and right ventricular end-diastolic area, long diameter, 24-segment end-diastolic transverse length (ED) and its Z-scores adjusted by gestational age and 24-segment spherical index(SI) were calculated by using fetal HQ. Subsequently the Z-scores of left and right ventricle fractional shortening (FS) in 24 segments were obtained by gestational age.Results:SI of 24-segments of left ventricles in fetuses with LVOTO were significantly different from that of right ventricles (all P<0.05). There was significant difference between left and right ventricular areas ( P<0.05). There was no significant difference between left and right ventricular lengths ( P>0.05). There were significant differences between the 24-segment Z-scores of left and right ventricular ED(all P<0.05). The ratios of RVED to LVED of 24 segments were analyzed by box diagram. The results showed that the transverse length of right ventricle was significantly higher than that of left ventricle. The highest value was 1.49(1.26-1.86), and the lowest value was 1.40(1.26-1.86), both significantly higher than the normal value of 1.19. There were no significant differences between the 1-19-segment Z-scores of left and right ventricular FS( P>0.05). There were significant differences between the 20-24-segment Z-scores of left and right ventricular FS( P<0.05). Conclusions:Fetal HQ can be used to quantitatively analyze left ventricular shape, size and function of fetuses with LVOTO, which provides a new method for quantitative analysis of fetal heart function.

Study on the feasibility of automatic quantification of cardiac axis by fetal intelligent navigation echocardiography / 中华超声影像学杂志

Objective:To explore the feasibility of fetal intelligent navigation echocardiography (FINE) in automatic quantitation of cardiac axis (CA).Methods:A total of 62 pregnant women of which 2 with twins′ pregnancy in the second and third trimesters from May to June 2020 in Sir Run Run Shaw Hospital Zhejiang University College of Medicine were enrolled in this non-selective and prospective study. After excluding those who could not be analyzed, they were assigned into four groups according to their CA measuring methods: ①Group with manual measuring CA in systole (CAS); ②Group with manual measuring CA in diastole(CAD); ③Group with CA measured by FINE in three-steps; ④Group with CA measured by FINE in seven-steps. The CAS among groups were compared in order to analyze the consistency and correlation of CAS achieved by different methods, meanwhile, the intra-observer and inter-observer consistency and repeatability were also evaluated.Results:A total of 64 fetuses with 187 volume data were collected, of which 60 cases of fetal data can be included in the study, 57 cases of normal CA, 3 cases of abnormal CA, a total of 158 volume data can be used for data analysis, the success rate was about 84.5%. Because of the small number of abnormal CA cases (3 cases), only 57 cases of normal CA were statistically analyzed in this study. Three-step and seven-step FINE automatic quantitative CA showed significantly different from those obtained with manual measurements of CAD ( P=0.005, P<0.001). There were no significant differences in quantitative analysis of CA between three-step or seven-step FINE and manual measurements of CAS ( P=0.458, 0.883), however, there was no correlation between CA using three-step FINE and manual measurement of CAS ( rs=0.056, P=0.679), but there was a positive correlation between CA using seven-step FINE and manual measurement of CAS ( rs=0.599, P<0.001). The linear regression equation was constructed as follows: Y=10.96+ 0.73 X ( R2=0.431, P<0.001). There was no correlation between three-step method and seven-step method for automatic quantitative CA ( rs=0.158, P=0.241). There was significant difference( P<0.001), but strong correlation between manual measurement of CAS and manual measurement of CAD ( rs=0.973, P<0.001), the average difference was ΔCA=(4.5± 3.8)°. The linear regression equation was constructed as follows: Y=-2.94+ 0.96 X ( R2=0.950, P<0.001). Intra-observer and inter-observer measurements had shown no significant difference in consistency and repeatability (all P>0.05). Conclusions:The measurement of fetal CA by seven-step FINE is superior to the three-step FINE when the fetal CA is in normal range. This may be considered a promising aspect that seven-step FINE automatic quantitation of fetal CA can replace the manual measurement of CAS. Future research is needed to deliminate the reliability of automatic quantification of fetal CA by seven-step FINE with the CA in abnormal range.

Sequential interventional therapy for Budd-Chiari syndrome associated with fresh inferior vena cava thrombosis.

OBJECTIVE: Our study aimed to evaluate the safety and efficacy of sequential interventional therapy for Budd-Chiari syndrome (BCS) caused by obstruction of the inferior vena cava (IVC) with fresh thrombus in the IVC. METHODS: Full medical records were obtained for 20 patients with BCS associated with fresh IVC thrombus who received sequential interventional therapy from 2014 to 2019 at our hospital. All patients underwent small-diameter percutaneous transluminal angioplasty (PTA) balloon catheter predilation combined with sequential catheter-directed thrombolysis and large-diameter PTA balloon dilation. Ultrasound examinations were performed at 1 week, 1 month, 3 months, and every 6 months thereafter. Therapeutic effects and perioperative and postoperative adverse effects were recorded to assess the safety of the treatment. RESULTS: All 20 patients were treated with small PTA balloon catheters (diameter, 10-14 mm) to predilate the occlusive segment of the IVC. Urokinase 400,000 to 600,000 (465,000 ± 93,000) units was administered to patients through the catheter for 6 to 20 (9.7 ± 4.2) consecutive days postoperatively. Ultrasound re-examination showed that the IVC thrombus disappeared completely in 14 patients (70.0%), and a small amount of the old thrombus remained in 6 patients (30.0%). After thrombolysis, all 20 patients received PTA balloon dilation (diameter, 26-30 mm) in the stenosed IVC segment, and blood flow recovered subsequently. No pulmonary embolism or death occurred in the perioperative course. The perioperative survival rate was 100.0%. CONCLUSIONS: Sequential interventional therapy for BCS associated with fresh IVC thrombus is safe and effective.

Comparative transcriptome analysis reveals the intensive early-stage responses of host cells to SARS-CoV-2 infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a widespread outbreak of highly pathogenic COVID-19. It is therefore important and timely to characterize interactions between the virus and host cell at the molecular level to understand its disease pathogenesis. To gain insights, we performed high-throughput sequencing that generated time-series data simultaneously for bioinformatics analysis of virus genomes and host transcriptomes implicated in SARS-CoV-2 infection. Our analysis results showed that the rapid growth of the virus was accompanied by an early intensive response of host genes. We also systematically compared the molecular footprints of the host cells in response to SARS-CoV-2, SARS-CoV and MERS-CoV. Upon infection, SARS-CoV-2 induced hundreds of up-regulated host genes hallmarked by a significant cytokine production followed by virus-specific host antiviral responses. While the cytokine and antiviral responses triggered by SARS-CoV and MERS-CoV were only observed during the late stage of infection, the host antiviral responses during the SARS-CoV-2 infection were gradually enhanced lagging behind the production of cytokine. The early rapid host responses were potentially attributed to the high efficiency of SARS-CoV-2 entry into host cells, underscored by evidence of a remarkably up-regulated gene expression of TPRMSS2 soon after infection. Taken together, our findings provide novel molecular insights into the mechanisms underlying the infectivity and pathogenicity of SARS-CoV-2.

An interventional radiology technique to treat pharyngeal or esophageal perforation associated with mediastinal abscess in children.

PURPOSE: Pharyngeal or esophageal perforation with mediastinal abscess is notably dangerous in children and can be very difficult to treat. We aimed to determine the safety and efficacy of the transnasal placement of a mediastinal drainage catheter and a nasojejunal feeding tube, with or without gastric decompression, in the treatment of the above perforations in children. METHODS: We placed transnasal mediastinal drainage catheters and nasojejunal feeding tubes in 14 pediatric patients. Patients with esophageal perforation also underwent the placement of a gastric decompression tube. Four of these patients additionally received chest drainage tubes. RESULTS: The fistula healed after a median of 66 days (range, 5-404 days). Corrosive esophagitis occurred in two patients with pharyngeal perforations. One of these patients underwent surgical treatment 2 months after fistula healing, and the other underwent repeated balloon dilatation procedures for cicatricial restenosis. Four months after the fistula had healed, the patients with esophageal perforations were all free from recurrence. CONCLUSION: The use of interventional radiology to place a transnasal mediastinal drainage catheter, a nasojejunal feeding tube, and a gastric decompression tube is a safe, easy, inexpensive, and efficacious way to treat pharyngeal or esophageal perforation complicated by mediastinal abscess in children. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: Level IV.

Permeation mechanism of phenolic acid components from traditional Chinese medicine on PES membrane separation process / 中国中药杂志

To explore the permeation mechanism of micro-molecule medicinal ingredients of water extract of tradition Chinese medicine(TCM) in membrane separation process. With phenolic acid components as the model solute, five phenolic acids with similar molecular weight and structure, namely gallic acid, protocatechuate acid, 4-hydroxybenzoic acid, 3-hydroxybenzoic acid and salicylic acid, were selected in the PES membrane separation experiments. With the relative flux and the transmission rate as indexes, the scanning electron microscopy(SEM) and the electrochemical impedance spectroscopy(EIS) were used to analyze the permeation mechanism of different phenolic acid components. The results showed phenolic acids with similar molecular weight had different permeation behaviors, with decreased relative flux and increased solute permeation with the increase of solute concentration. According to the permeation behavior analyzed by the molecular structure of solute, the transmission rate of phenolic acids increased with the increase of the number of hydroxyl, and the order of substituent positions of phenolic acids based on the permeation rate as follows: para-substituted > meta-substitution > ortho-substitution. Electrochemical impedance spectroscopy reflected the role of charge repulsion in the membrane process; that is to say, the greater the resistance is, the less the solute permeation is. Therefore, the permeation phenomenon of the phenolic acid components in the PES membrane is not only the result of simple sieving mechanisms, but also has the effects of steric hindrance and charge repulsion during the membrane process.

A feasibility study of fetal intelligent navigation echocardiography in the prenatal screening of right aortic arch with left-sided ductus arteriosus / 中华超声影像学杂志

Objective:To investigate the feasibility of applying Fetal Intelligent Navigation Echocardiography (FINE) combined with Virtual Intelligent Sonographer Assistance (VIS-Assistance ?) in the prenatal screening of right aortic arch (RAA) with left-sided ductus arteriosus (LDA). Methods:A total of 32 fetuses with RAA and LDA during middle and late pregnancy in Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital from Jauary 2018 to Jauary 2020 were included in this retrospective study, and the datas about fetal cardiac three-dimensional volume were analyzed. The time-space correlation imaging (STIC) volume data were collected by using FINE by Senior doctor A. The two diagnostic elements of the transverse aortic arch on the right side of the trachea and the "U" -shaped vascular ring, as well as the three-vessel tracheal diagnostic section were obtained by low-aged doctor B and middle-aged doctor C by using VIS-Assistance ? technology. And then the detection rates of diagnostic sections and diagnostic elements for fetuses with RAA and LDA were calculated. The postpartum outcomes of fetuses with RAA and LDA were followed up. Results:Thirty-two fetuses were included in the study after excluding 2 cases due to the poor quality images, and the datas about fetal cardiac three-dimensional volume of the 32 fetuses were analyzed. The detection rate of one diagnostic element (the aortic arch on the right side of the trachea) were 84.4% vs 87.5% before VIS-Assistance ?, and 93.8% vs 93.8% after VIS-Assistance ? for each doctor B and doctor C , respectively. Another diagnostic element ( "U" -shaped vascular ring) were 78.1% vs 87.3% before VIS-Assistance ?, and 90.6% vs 90.6% after VIS-Assistance ? for doctor B and doctor C, respectively. But no significant difference was found before and after VIS-Assistance ? between the two each doctors(all P>0.05). The detection rate of three-vascular tracheal diagnosis view were 65.6% vs 71.9% before VIS-Assistance ? and 84.4% vs 87.5% after VIS-Assistance ? for doctor B and doctor C, respectively. There was significant difference before and after VIS-Assistance ? of doctor C( P<0.05). The scores of image quality after VIS-Assistance ? were significantly higher than that before VIS-Assistance ? for doctor B and doctor C, respectively [3(2.5, 3) vs 3.25(3.0, 3.5), and 3(2.5, 3.5) vs 3.5(3.0, 3.5)]. The agreement between two doctors performing VIS-Assistance ? was investigated using Bland-Altman analysis and the result showed that within 95% of the differences fall in the agreement interval. No obvious clinical symptoms of compression were found in 32 neonates after follow-up. Conclusions:The application of FINE combined with VIS-Assistance ? technology can easily and reliably obtain the key diagnostic view of RAA with LDA (three-vessel and tracheal view), and clearly display all diagnostic elements, having high repeatability and stability. VIS-Assistance ? technology can improve the detection rate and image quality even if the doctor was lack of experience. So it can be used as an effective supplementary means for prenatal screening of RAA and LDA.