Introducing the ratio of cross diameters of the appendix for ultrasound diagnosis of acute appendicitis can significantly increase specificity.

PURPOSE: To validate whether the introduction of the ratio of the cross diameters on the transverse section of the appendix (RATIO) ≤ 1.18 is useful for improving the ultrasound diagnosis of acute appendicitis (AA). METHODS: Data from 220 patients with AA and 110 patients with a normal appendix were retrospectively studied. The RATIO ≤ 1.18, maximal outer diameter (MOD) > 6 mm, and a combination of RATIO ≤ 1.18 and MOD > 6 mm were used for predicting AA. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. RESULTS: The RATIO ≤ 1.18, MOD > 6 mm, and a combination of RATIO ≤ 1.18 and MOD > 6 mm for predicting AA showed a sensitivity of 90, 100, and 90%; specificity of 79.1, 27.3, and 88.2%; and AUC of 0.845, 0.636, and 0.891, respectively. When comparing the outcomes between MOD > 6 mm and a combination of MOD > 6 mm and RATIO ≤ 1.18, the specificity and PPV increased from 27.3 to 88.2% and 73.3 to 93.8%, respectively (all P < 0.0001). The sensitivity and NPV decreased from 100 to 90% and 100 to 81.5%, respectively (all P < 0.0001). The AUC increased from 0.636 to 0.891 (P < 0.0001). When comparing the AUC of MOD > 6 mm, and a combination of RATIO ≤ 1.18 and MOD > 6 mm for predicting AA with the AUC in a previous study, there were no significant differences between each other (all P > 0.05). CONCLUSION: Introducing the RATIO ≤ 1.18 for the evaluation of AA can improve the diagnostic performance and significantly increase specificity.

Advancements in Biosensors for Point-of-Care Testing of Nucleic Acid.

Rapid, low-cost and high-specific diagnosis based on nucleic acid detection is pivotal in both detecting and controlling various infectious diseases, effectively curbing their spread. Moreover, the analysis of circulating DNA in whole blood has emerged as a promising noninvasive strategy for cancer diagnosis and monitoring. Although traditional nucleic acid detection methods are reliable, their time-consuming and intricate processes restrict their application in rapid field assays. Consequently, an urgent emphasis on point-of-care testing (POCT) of nucleic acids has arisen. POCT enables timely and efficient detection of specific sequences, acting as a deterrent against infection sources and potential tumor threats. To address this imperative need, it is essential to consolidate key aspects and chart future directions in POCT biosensors development. This review aims to provide an exhaustive and meticulous analysis of recent advancements in POCT devices for nucleic acid diagnosis. It will comprehensively compare these devices across crucial dimensions, encompassing their integrated structures, the synthesized nanomaterials harnessed, and the sophisticated detection principles employed. By conducting a rigorous evaluation of the current research landscape, this review will not only spotlight achievements but also identify limitations, offering valuable insights into the future trajectory of nucleic acid POCT biosensors. Through this comprehensive analysis, the review aspires to serve as an indispensable guide for fostering the development of more potent biosensors, consequently fostering precise and efficient POCT applications for nucleic acids.

Platinum Black/Gold Nanoparticles/Polyaniline Modified Electrochemical Microneedle Sensors for Continuous In Vivo Monitoring of pH Value.

Continuous in vivo monitoring (CIVM) of pH value is essential for personalized medicine, as many diseases are closely related to acid-base imbalances. However, conventional pH meters are limited in their ability to perform CIVM due to excessive blood consumption, large device volume, frequent calibration, and inadequate real-time monitoring. There is thus an urgent need for a portable method for CIVM of pH value. To address this need, we propose a minimally invasive, continuous monitoring solution in the form of an implantable pH microneedle sensor (MNS) in this study. The MNS is based on the integration of an acupuncture needle (AN) and a Ag/AgCl reference electrode. We fabricate the sensor by electrochemically depositing platinum black and gold nanoparticles onto the AN and further modifying it with polyaniline to increase its sensitivity to hydrogen ions. The pH value is obtained by calculating the open circuit voltage between the modified AN and the reference electrode. The resulting MNS demonstrates excellent selectivity and a high nernstian response to pH (-57.4 mV per pH) over a broad range (pH = 4.0 to pH = 9.0). Both in vitro and in vivo experiments have verified the performance of the sensor, showcasing its potential for biomedical research and clinical practice. The MNS provides an alternative to conventional pH meters, offering a less invasive and more convenient way to perform CIVM of pH value. Moreover, this electrochemical implantable sensor based on AN and silver wires provides a simple and sensitive method for continuous in vivo detection of other biomarkers.

QiShen YiQi and its components attenuate acute thromboembolic stroke and carotid thrombosis by inhibition of CD62P/PSGL-1-mediated platelet-leukocyte aggregate formation.

BACKGROUND: QiShen YiQi (QSYQ) dropping pill, a component-based Chinese medicine consisting of benefiting Qi (YQ) and activating blood (HX) components, has been reported to exert a beneficial effect on cerebral ischemia-induced stroke. However, its efficacy and pharmacological mechanism on acute thromboembolic stroke is not clear. PURPOSE: This study is to explore the preventative effect and pharmacological mechanism of QSYQ and its YQ/HX components on the formation of platelet-leukocyte aggregation (PLA) in acute thromboembolic stroke. STUDY DESIGN AND METHODS: In vivo thromboembolic stroke model and FeCl3-induced carotid arterial occlusion models were used. Immunohistochemistry, Western blot, RT-qPCR, and flow cytometry experiments were performed to reveal the pharmacological mechanisms of QSYQ and its YQ/HX components. RESULTS: In thromboembolic stroke rats, QSYQ significantly attenuated infarct area, improved neurological recovery, reduced PLA formation, and inhibited P-selection (CD62P)/ P-selectin glycoprotein ligand-1 (PSGL-1) expressions. The YQ component preferentially down-regulated PSGL-1 expression in leukocyte, while the HX component preferentially down-regulated CD62P expression in platelet. In carotid arterial thrombosis mice, QSYQ and its YQ/HX components inhibited thrombus formation, prolonged vessel occlusion time, reduced circulating leukocytes and P-selectin expression. PLA formation and platelet/leukocyte adhesion to endothelial cell were also inhibited by QSYQ and its YQ/HX components in vitro. CONCLUSION: QSYQ and YQ/HX components attenuated thromboembolic stroke and carotid thrombosis by decreasing PLA formation via inhibiting CD62P/PSGL-1 expressions. This study shed a new light on the prevention of thromboembolic stroke.

Identification of linoleic acid as an antithrombotic component of Wenxin Keli via selective inhibition of p-selectin-mediated platelet activation.

Atrial fibrillation significantly increases the risk of thromboembolism and stroke. Wenxin Keli (WXKL) is a widely used Chinese patent medicine against arrhythmia but if it has antithrombotic activity is unknown. Since platelet activation is a critical factor in thrombosis and the key target for many antithrombotic drugs, this study aims to demonstrate the antithrombotic efficacy of WXKL. In vitro platelet activation experiments showed that WXKL significantly inhibited platelet adhesion and aggregation. The potential active monomers in WXKL were screened by in silico prediction and in vitro platelet aggregation/adhesion assays. From WXKL chemical fractions and more than 40 monomers, linoleic acid (LA) was identified as the strongest antiplatelet compound. Oral administration of WXKL (1.2 g/kg/day) and LA (50 mg/kg/day) for 7 days significantly improved FeCl3-induced carotid thrombus formation in ICR mice without prolonging bleeding time. Flow cytometry showed that both WXKL and LA inhibited the release of p-selectin after platelet activation. ELISA showed that WXKL and LA also inhibited the expression of 6-Keto-PGF1α in plasma of mice with thrombus, but had no obvious effect on the expression of TXB2. WXKL inhibited platelet activation by broadly inhibiting the phosphorylation of protein kinase B (Akt), mitogen-activated protein kinases (MAPKs) and phospholipase C (PLC) ß3. In contrast, LA only inhibited the phosphorylation of PLCß3. In conclusion, WXKL and its active component LA showed good antiplatelet and antithrombotic efficacy in vivo and in vitro. Mechanistically, the multicomponent Chinese medicine WXKL acts on multiple targets in the platelet activation pathway whereas its active monomer linoleic acid acts specifically on phospholipase C ß3.

Manufacturing of a Compact Micro Air Bearing Device for Power Micro Electro Mechanical System (MEMS) Applications Using Silica Film Assisted Processing.

The focus of this study is on the manufacturing of micro air bearings (MABs) using silica film assisted processing. Structure of the three-layer micro air bearing is described in detail and the salient process flow of etching and bonding is illustrated. The main manufacturing challenges and the methods adopted to overcome them are also presented. The uniformity of wet etching for nozzles with 20 µm in diameter to silica film is improved by adopting an ultrasound assisted method. Particular attention is given to the novel fabrication procedures for the second layer of MAB (with three depths on aft side). This paper develops new applications of silica film in Micro Electro Mechanical System (MEMS) processing for MABs to realize the etching of multi-depth on the same side and efficient three-layer bonding with increased bonding areas. A silica etch mask is proven to achieve a higher accuracy in surface topography when compared to a photoresist mask for multi-depth etching, resulting in precise depth and vertical control. The bonding rate of three-layer direct bonding for MAB is increased by 50% from 0.05 to 0.1 with the novel silica film protection method.

Anti-Reflectance Optimization of Secondary Nanostructured Black Silicon Grown on Micro-Structured Arrays.

Owing to its extremely low light absorption, black silicon has been widely investigated and reported in recent years, and simultaneously applied to various disciplines. Black silicon is, in general, fabricated on flat surfaces based on the silicon substrate. However, with three normal fabrication methods-plasma dry etching, metal-assisted wet etching, and femtosecond laser pulse etching-black silicon cannot perform easily due to its lowest absorption and thus some studies remained in the laboratory stage. This paper puts forward a novel secondary nanostructured black silicon, which uses the dry-wet hybrid fabrication method to achieve secondary nanostructures. In consideration of the influence of the structure's size, this paper fabricated different sizes of secondary nanostructured black silicon and compared their absorptions with each other. A total of 0.5% reflectance and 98% absorption efficiency of the pit sample were achieved with a diameter of 117.1 µm and a depth of 72.6 µm. In addition, the variation tendency of the absorption efficiency is not solely monotone increasing or monotone decreasing, but firstly increasing and then decreasing. By using a statistical image processing method, nanostructures with diameters between 20 and 30 nm are the majority and nanostructures with a diameter between 10 and 40 nm account for 81% of the diameters.

Anti-reflectance investigation of a micro-nano hybrid structure fabricated by dry/wet etching methods.

Black silicon fabrication and manipulation have been well reported by institutes around the world and are quite useful for solar absorption and photovoltaic conversion. In this study, silicon micro-nano hybrid structures were fabricated, and the morphologies of the hybrid structures were analyzed. This paper studied nanostructures formed on tips, pits and a flat surface using a dry etching method and a wet etching method. In terms of nanostructure morphology, nanostructures etched by the wet etching method (13 µm) were taller than those etched by the dry etching method (1 µm), but the wet etched morphology was less organized. After the nanostructures were grown, six samples with nano sturctures and three samples with micro sturctures were measured by a photometer for reflectivity testing. The nine samples were compared and analyzed using the integral of reflectivity and solar emissivity at the earth's surface. The results show that the nanostructures grown on a tip surface using the wet etching method had the minimum reflectivity in the wavelength range of 300 nm-1100 nm, in consideration of the forbidden energy gap of silicon.

Prognostic significances of overexpression MYC and/or BCL2 in R-CHOP-treated diffuse large B-cell lymphoma: A Systematic review and meta-analysis.

Numerous studies have investigated the prognostic values of MYC and/or BCL2 protein overexpression in diffuse large B-cell lymphoma (DLBCL). However, the results still demonstrate discrepancies among different studies. We aimed to do a systematic review and meta-analysis on the relationships between overexpression MYC and/or BCL2 and DLBCLs treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). This study followed the guidelines of PRISMA and Cochrane handbook. The hazard ratios (HRs) for overall survival (OS) were pooled to estimate the main effect size. Twenty studies recruited a total of 5576 patients were available for this meta-analysis. The results showed that MYC (HR = 1.96, 95%CI (confidence interval) = 1.69-2.27)without heterogeneity(I2 = 17.2%, P = 0.280), BCL2 (HR = 1.65, 95%CI = 1.43-1.89, I2 = 20.7%, P = 0.234) protein overexpression, and co-overexpression (HR = 2.58, 95%CI = 2.19-3.04, I2 = 17.2%, P = 0.275) had a poor prognosis in R-CHOP treated DLBCL patients, respectively. The current analysis indicated that MYC and/or BCL2 protein overexpression, and particularly co-overexpression was related to short overall survival in R-CHOP treated DLBCL patients, showing that application of the two new biomarkers can help to better stratify DLBCL patients and guide targeted treatment.

External validation of non-invasive prediction models for identifying ultrasonography-diagnosed fatty liver disease in a Chinese population.

Several prediction models for fatty liver disease (FLD) are available with limited externally validation and less comprehensive evaluation. The aim was to perform external validation and direct comparison of 4 prediction models (the Fatty Liver Index, the Hepatic Steatosis Index, the ZJU index, and the Framingham Steatosis Index) for FLD both in the overall population and the obese subpopulation.This cross-sectional study included 4247 subjects aged 20 to 65 years recruited from the north of Shanxi Province in China. Anthropometric and biochemical features were collected using standard protocols. FLD was diagnosed by liver ultrasonography. We assessed all models in terms of discrimination, calibration, and decision curve analysis.The original models performed well in terms of discrimination for the overall population, with the area under the receiver operating characteristic curves (AUCs) around 0.85, while AUCs for obese individuals were around 0.68. Nevertheless, the predicted risks did not match well with the observed risks both in the overall population and the obese subpopulation. The FLI 2006 was 1 of the 2 best models in terms of discrimination (AUCs were 0.87 and 0.72 for the overall population and the obese subgroup, respectively) and had the best performance in terms of calibration, and attained the highest net benefit.The FLI 2006 is overall the best tool to identify high risk individuals and has great clinical utility. Nonetheless, it does not perform well enough to quantify the actual risk of FLD, which need to be (re)calibrated for clinical use.

Burn injuries associated with the water tank of motorfarming tricycles in China.

Burns caused by hot coolant from the reservoir of motorfarming tricycles have not been reported previously. We performed retrospective studies of such cases in 126 patients with complete records in rural areas of China. The majority of victims were unmarried (59.5%), young (<40 years, >20, 55.6%), and male (male to female ratio 9:1). The burn accident occurred mostly during the busy seasons of spring and summer (66.7%). The mechanism of injury was usually the same. The drivers were trapped under the farming tricycle in a traffic accident and then hot coolant leaked from the mouth of the coolant, resulting in long contact with the hot fluid. The burn wounds were located mostly on the areas of the buttocks and lower extremities (especially on the thigh) (64.3%). The generally burned patients had moderate burn areas, about 20-50% total burn surface area (TBSA) of deep partial thickness or full thickness burn wound. For the purpose of decreasing the number of burns presenting, or at least making them less severe, the suggestions include: (1) the design of motorfarming tricycle should be changed; obviously separation of the coolant tank from the seat is the most important factor in reducing such burns. (2) Road conditions should be improved to reduce traffic accidents and loading regulations introduced. (3) Traffic control should be enhanced, especially in rural areas.