Simultaneous grading diagnosis of liver fibrosis, inflammation, and steatosis using multimodal quantitative ultrasound and artificial intelligence framework.

Noninvasive, accurate, and simultaneous grading of liver fibrosis, inflammation, and steatosis is valuable for reversing the progression and improving the prognosis quality of chronic liver diseases (CLDs). In this study, we established an artificial intelligence framework for simultaneous grading diagnosis of these three pathological types through fusing multimodal tissue characterization parameters dug by quantitative ultrasound methods derived from ultrasound radiofrequency signals, B-mode images, shear wave elastography images, and clinical ultrasound systems, using the liver biopsy results as the classification criteria. One hundred forty-two patients diagnosed with CLD were enrolled in this study. The results show that for the classification of fibrosis grade ≥ F1, ≥ F2, ≥ F3, and F4, the highest AUCs were respectively 0.69, 0.82, 0.84, and 0.88 with single clinical indicator alone, and were 0.81, 0.83, 0.89, and 0.91 with the proposed method. For the classification of inflammation grade ≥ A2 and A3, the highest AUCs were respectively 0.66 and 0.76 with single clinical indicator alone and were 0.80 and 0.93 with the proposed method. For the classification of steatosis grade ≥ S1 and ≥ S2, the highest AUCs were respectively 0.71 and 0.90 with single clinical indicator alone and were 0.75 and 0.92 with the proposed method. The proposed method can effectively improve the grading diagnosis performance compared with the present clinical indicators and has potential applications for noninvasive, accurate, and simultaneous diagnosis of CLDs.

Changing ALK-TKI mechanisms of resistance in re-biopsies of ALK-rearranged NSCLC: ALK mutations followed by SCLC-like histologic transformation: A case report.

Anaplastic lymphoma kinase (ALK) inhibitors are the recommended treatment of ALK-rearranged non-small cell lung cancer but are prone to eventual drug resistance. Herein we report a 45-year-old Asian woman diagnosed with EML4-ALK rearranged lung adenocarcinoma. Small cell lung cancer-like phenotypic transformation occurred when resistance to crizotinib treatment. Next-generation sequencing was performed and detected an ALK rearrangement co-existent with a TP53 gene mutation in the small cell specimens. The patient had a good response to alectinib with a progression-free survival >7 months. After disease progression, newly emerged ALK p.G1269A and p.L1196 M gene mutations co-existent with ALK rearrangement were detected. The patient had a good initial response to ceritinib treatment, which last for >12 months. After ceritinib failure, however, more complicated mutations within the ALK kinase domain (p.G1269A, p.L1196 M, newly emerged p.D1203 N, and p.L1122V) were detected. Ultimately, due to terminal rapid progression and resistance to lorlatinib, the overall survival was nearly 3 years. Our case showed that next-generation ALK-tyrosine kinase inhibitors (TKIs) may be an appropriate choice after transformation to small cell lung cancer and failure to one ALK-TKI. Sequential biopsies and gene mutation monitoring are important to arrange the sequence of different generation ALK-TKIs. Appropriate sequential therapies may yield a prolonged response with a satisfactory quality of life in patients with advanced ALK-rearranged non-small cell lung cancer.

Single-molecule detection of SARS-CoV-2 N protein on multilayered plasmonic nanotraps with surface-enhanced Raman spectroscopy.

The spread of the SARS-CoV-2 virus has had an unprecedented impact, both by posing a serious risk to human health and by amplifying the burden on the global economy. The rapid identification of the SARS-CoV-2 virus has been crucial to preventing and controlling the spread of SARS-CoV-2 infections. In this study, we propose a multilayered plasmonic nanotrap (MPNT) device for the rapid identification of single particles of SARS-CoV-2 virus in ultra-high sensitivity by surface-enhanced Raman scattering (SERS). The MPNT device is composed of arrays of concentric cylindrical cavities with Ag/SiO2/Ag multilayers deposited on the top and at the bottom. By varying the diameter of the cylinders and the thickness of the multilayers, the resonant optical absorption and local electric field were optimized. The SERS enhancement factors of the proposed device are of the order of 108, which enable the rapid identification of SARS-CoV-2 N protein in concentrations as low as 1.25 × 10-15－12.5 × 10-15 g mL-1 within 1 min. The developed MPNT SERS device provides a label-free and rapid detection platform for SARS-CoV-2 virus. The general nature of the device makes it equally suitable to detect other infectious viruses.

Simultaneous Circular Dichroism and Wavefront Manipulation with Generalized Pancharatnam-Berry Phase Metasurfaces.

Simultaneous circular dichroism and wavefront manipulation have gained considerable attention in various applications, such as chiroptical spectroscopy, chiral imaging, sorting and detection of enantiomers, and quantum optics, which can improve the miniaturization and integration of the optical system. Typically, structures with n-fold rotational symmetry (n ≥ 3) are used to improve circular dichroism, as they induce stronger interactions between the electric and magnetic fields. However, manipulating the wavefront with these structures remains challenging because they are commonly considered isotropic and lack a geometric phase response in linear optics. Here, we propose and experimentally demonstrate an approach to achieve simultaneous circular dichroism (with a maximum value of ∼0.62) and wavefront manipulation using a plasmonic metasurface made up of C3 Archimedes spiral nanostructures. The circular dichroism arises from the magnetic dipole-dipole resonance and strong interactions between adjacent meta-atoms. As a proof of concept, two metadevices are fabricated and characterized in the near-infrared regime. This configuration possesses the potential for future applications in photodetection, chiroptical spectroscopy, and the customization of linear and nonlinear optical responses.

First report of Fusarium commune Causing Bulb Rot on Lily (Lilium brownii var. Viridulum Baker) in Hunan Province of China.

Lily (Lilium brownii var. Viridulum Baker) is a well-known edible plant with large, white and sweet bulb scales that has important medicinal value (Zhou et al. 2021) and is grown mainly in the Hebei, Shanxi and Henan provinces of China. In May 2021, a case of bulb rot was discovered in a 3.33 hm2 plantation in Huaihua, Hunan Province, affecting 20% of the area (27°59'30″N, 110°32'20″E). The disease is most severe during the rainy season in May and June. In the early stage, irregular brown spots appeared on the lily scales, the necrosis was depressed and gradually enlarges, and in the later stage, the scales were scattered from the base of the disc and slough off. Ten samples were taken randomly from different plants in the plantation area to isolate the pathogens. After washing with sterile water, they were cut into small pieces and sterilised with 3% hydrogen peroxide for 30 s, 75% ethanol for 90 s, rinsed three times with sterile water and dried on sterile filter paper, then placed on a water agar plate and incubated in the dark in a constant temperature incubator at 28℃ for 3 to 5 days. After 2 days, the mycelium at the edge of the colony was transferred to a PDA plate and incubated for 3-5 days at 28°C in the dark to obtain pure fungal isolates. Eighteen purified fungal isolates were obtained, of which sixteen looked like Fusarium (88.9% isolation rate) and three representative isolates (BHBR2, BHBR3 and BHBR5) were selected for further study. The surface of this fungus was white with dense aerial mycelium. Some had an orange centre in the medium. Microconidia were oval in shape and appeared either straight or slightly curved. These microconidia were colourless, had 0-1 septa and measured 3.334 to 14.724 × 2.216 to 5.385 µm (n=100). Macroconidia were predominantly three-septate, crescent-shaped structures that were thin-walled and slightly curved. Cells at the apex and base were similarly curved. Macroconidia measured 17.956 to 32.150 × 2.788 to 4.492 µm (n=100). The mitochondrial small subunit (mtSSU) and translation elongation factor 1-α (TEF1) genes were amplified and sequenced using the NMS1/NMS2 and TEF-R/TEF-F primers to verify the identity of the pathogens (Stewart et al. 2006). The sequences were submitted to GenBank (BHBR2: mtSSU, PP273435; TEF, OR900976; BHBR3: mtSSU, PP277729; TEF, OR900977; BHBR5: mtSSU, PP277728; TEF, OR900978). A concatenated phylogenetic tree of the two genes was constructed and analysis showed that BHBR2, BHBR3 and BHBR5 were significantly clustered with Fusarium commune. Based on the results of morphological identification and phylogenetic tree analysis, the three isolates were identified as Fusarium commune. We carried out pathogenicity tests using two methods, one in which 6 × 6 mm fungal blocks were inoculated on lily (L. brownie var. viridulum Baker) scales and controls inoculated with sterile blocks, and the other in which strain BHBR2 was selected to carry out pathogenicity tests on bulbs of live plants soaked with 50 ml of a 1 × 106 conidial suspension and bulbs of control plants soaked with sterile water, all in three replicates. They were placed in a growth chamber at 28°C and 80% relative humidity, and the scales were moistened with moistened sterile filter paper. After 3 days of rearing treated scales, lesions appeared on lily scales inoculated with mycelial blocks and expanded with time, whereas no lesions appeared on lily scales inoculated with sterile blocks. One month later, whole plants soaked in the spore suspension wilted, while the control plants grew well. The pathogens re-isolated from the diseased tissues had the same morphological characteristics as representative isolates. This confirms Koch's hypothesis. Fusarium commune has been shown to be the most important pathogenic fungus causing root rot in Alfalfa (Medicago sativa) (Yang et al. 2022) and blueberry (Vaccinium uliginosum L.) (Li et al. 2023) in China. To our knowledge, this is the first report of Fusarium commune causing lily bulb rot in the world, which will lay the foundation for future control of lily bulb rot.

A One-Stone-Two-Birds Strategy of Targeting Microbubbles with "Dual" Anti-Inflammatory and Blood-Brain Barrier "Switch" Function for Ischemic Stroke Treatment.

Inflammation is considered to be the main target of the development of new stroke therapies. There are three key issues in the treatment of stroke inflammation: the first one is how to overcome the blood-brain barrier (BBB) to achieve drug delivery, the second one is how to select drugs to treat stroke inflammation, and the third one is how to achieve targeted drug delivery. In this study, we constructed hydrocortisone-phosphatidylserine microbubbles and combined them with ultrasound (US)-targeted microbubble destruction technology to successfully open the BBB to achieve targeted drug delivery. Phosphatidylserine on the microbubbles was used for its "eat me" effect to increase the targeting of the microvesicles. In addition, we found that hydrocortisone can accelerate the closure of the BBB, achieving efficient drug delivery while reducing the entry of peripheral toxins into the brain. In the treatment of stroke inflammation, it was found that hydrocortisone itself has anti-inflammatory effects and can also change the polarization of microglia from the harmful pro-inflammatory M1 phenotype to the beneficial anti-inflammatory M2 phenotype, thus achieving dual anti-inflammatory effects and enhancing the anti-inflammatory effects in ischemic areas after stroke, well reducing the cerebellar infarction volume by inhibiting the inflammatory response after cerebral ischemia. A confocal microendoscope was used to directly observe the polarization of microglial cells in living animal models for dynamic microscopic visualization detection showing the advantage of being closer to clinical work. Taken together, this study constructed a multifunctional targeted US contrast agent with the function of "one-stone-two-birds", which can not only "on-off" the BBB but also have "two" anti-inflammatory functions, providing a new strategy of integrated anti-inflammatory targeted delivery and imaging monitoring for ischemic stroke treatment.

Perioperative care of neonates with critical pulmonary stenosis: Case report.

RATIONALE: Summarizing the perioperative nursing experience in the successful treatment of 4 neonates with critical pulmonary stenosis (CPS). PATIENT CONCERNS: Of the 4 patients, 3 had postnatal shortness of breath and varying degrees of cyanosis, aggravated by crying and noise, and 1 had no obvious shortness of breath and cyanosis. The preoperative auscultation of the precordial region could be heard 3-4/6 systolic murmur; echocardiography was diagnosed as CPS, combined with patent ductus arteriosus, right ventricular dysplasia, and severe tricuspid regurgitation. Four children were treated with prostaglandin 5 ng/(kg-min) to maintain a certain degree of pulmonary blood flow to improve hypoxemia, effectively preventing ductus arteriosus from closure, and the infusion was discontinued 2 hours prior to the operation. Three of the children required ventilator-assisted respiration to relieve severe hypoxia and correct acidosis before surgery. DIAGNOSIS: Neonatal CPS was diagnosed. INTERVENTIONS: Four neonates with rapidly developing conditions were admitted to the hospital, a multidisciplinary in-hospital consultation was organized immediately, and a multidisciplinary collaborative team was set up, consisting of medical doctors and nurses from the medical department, the neonatal intensive care unit, cardiovascular medicine, cardiac ultrasound room, anesthesiology department, and radiology and interventional medicine department. The multidisciplinary team evaluated the treatment modality of the children and finally decided to perform percutaneous balloon pulmonary valvuloplasty. The surgical team included specialists from the Department of Cardiovascular Medicine, Department of Interventional Radiology, Cardiac Ultrasound Unit, and Department of Anesthesiology. OUTCOMES: All 4 neonates were successfully operated and discharged from the hospital. Multidisciplinary follow-up interventions were carried out 1 year after discharge, and the children were in good condition. LESSONS: The specialty nursing-led multidisciplinary collaboration model significantly improves the professional competence of nurses from various specialties, promotes the integration and development of multispecialty disciplines, and provides better quality services for children, which is the key to improving the success rate of percutaneous balloon pulmonary valvuloplasty in neonates.

Circulating tumor DNA serial monitoring of relapse and responses to tislelizumab immunotherapy as second­line monotherapy for metastatic esophageal squamous cell carcinoma: A prospective study.

Anti-programmed cell death 1 immuno-monotherapy has become the second-line standard treatment for advanced esophageal squamous cell carcinoma (ESCC) after the failure of first-line chemotherapy. However, new biomarkers are still needed to identify patients at risk of tumor progression and to select patients with advanced ESCC who are likely to benefit from immunotherapy. A total of 12 patients with advanced ESCC treated with tislelizumab were prospectively enrolled and endoscopic biopsy samples were collected. Plasma was obtained prior to and after every 2-3 treatment cycles with tislelizumab and when disease progression occurred. Targeted sequencing of 425 genes from plasma cell-free DNA, DNA from leukocytes and fixed esophageal tumor biopsies was performed. The patients underwent imaging analyses every 6-8 weeks until disease progression. The association between status of circulating tumor DNA (ctDNA) or changes in ctDNA following tislelizumab immunotherapy and response, tumor progression and survival was determined. All patients had evaluable next-generation sequencing results at the time of analysis. The results showed that patients with ESCC with liver metastasis had a significantly shorter median progression-free survival (mPFS: 1.4 vs. 11.7 months; P=0.037). TSC complex subunit 2 [11.7 months vs. not reached (NR); P=0.004] and zinc finger protein 217 (11.7 months vs. NR; P=0.022) gene mutations were the independent and negative prognostic factors for median overall survival (OS), respectively. Of note, ctDNA dynamic changes expressed as ∆ mutant molecules per milliliter of plasma (∆MMPM; MMPM detected at the first monitoring time-point after the first infusion of tislelizumab as baseline MMPM) predicted progression-free survival (PFS) and OS more accurately compared to the ctDNA change of an individual gene. ∆MMPM <20% was an independent predictor of PFS (2.8 vs. 14.6 months; P=0.029), although there was no significant difference for OS (16.7 vs. 17.6 months; P=0.830). In conclusion, changes in ctDNA levels were associated with anti-tumor effects, progression and disease-specific survival. ctDNA sequencing is promising for predicting response and progression after tislelizumab immunotherapy as second-line monotherapy for advanced ESCC [the present study was part of the RATIONALE-302 study (ClinicalTrials.gov identifier no. NCT03430843; 29.01.2018)].

[Screening of bioactive components endowing hawthorn with turbidity-eliminating and lipid-lowering functions and development of quality control method of hawthorn].

Hawthorn has the efficacy of eliminating turbidity and lowering the blood lipid level, and it is used for treating hyperlipidemia in clinic. However, the bioactive components of hawthorn are still unclear. In this study, the spectrum-effect relationship was employed to screen the bioactive components of hawthorn in the treatment of hyperlipidemia, and then the bioactive components screened out were verified in vivo. Furthermore, the quality control method for hawthorn was developed based on liquid chromatography-mass spectrometry(LC-MS). The hyperlipidemia model of rats was built, and different polar fractions of hawthorn extracts and their combinations were administrated by gavage. The effects of different hawthorn extract fractions on the total cholesterol(TC), triglycerides(TG), and low-density lipoprotein-cholesterol(LDL-C) in the serum of model rats were studied. The orthogonal projections to latent structures(OPLS) algorithm was used to establish the spectrum-effect relationship model between the 24 chemical components of hawthorn and the pharmacodynamic indexes, and the bioactive components were screened out and verified in vivo. Finally, 10 chemical components of hawthorn, including citric acid and quinic acid, were selected to establish the method for evaluating hawthorn quality based on LC-MS. The results showed that different polar fractions of hawthorn extracts and their combinations regulated the TG, TC, and LDL-C levels in the serum of the model rats. The bioactive components of hawthorn screened by the OPLS model were vitexin-4″-O-glucoside, vitexin-2″-O-rhamnoside, rutin, citric acid, malic acid, and quinic acid. The 10 chemical components of hawthorn, i.e., citric acid, quinic acid, rutin, gallic acid, vitexin-4″-O-glucoside, vitexin-2″-O-rhamnoside, malic acid, vanillic acid, neochlorogenic acid, and fumaric acid were determined, with the average content of 38, 11, 0.018, 0.009 5, 0.037, 0.017, 8.1, 0.009 5, 0.073, and 0.98 mg·g~(-1), respectively. This study provided a scientific basis for elucidating the material basis of hawthorn in treating hyperlipidemia and developed a content determination method for evaluating the quality of hawthorn.

Size-controllable synthesis of large-size spherical 3D covalent organic frameworks as efficient on-line solid-phase extraction sorbents coupled to HPLC.

BACKGROUND: Covalent organic frameworks (COFs) have found promising applications in separation fields due to their large surface area and high adsorption capacity, but the exiting COFs can not be directly used as the packing materials of on-line solid-phase extraction (SPE) coupled to HPLC and HPLC because their nano/submicron size or irregular shapes might cause ultrahigh column back pressure and low column efficiency. To synthesize the large-size spherical COFs larger than 3 µm as sorbents might be able to address these problems, however it is still a great challenge till now. RESULTS: In this work, two large-size spherical 3D COFs (COF-320 and COF-300) were size-controllably synthesized within 10-90 µm via a two-step strategy. These two spherical COFs showed large surface area, fine crystallinity, good chemical/mechanical stability, and good reproducibility. As an application case, when used as the on-line SPE sorbents coupled to HPLC, the large-size spherical COF-320 displayed high binding capacity for bisphenol F (Qmax of 452.49 mg/g), low column back pressure (6-8 psi at flow rate of 1 mL/min), and good reusability (at least 30 cycles). The developed on-line-SPE-HPLC-UV method presented good analytical performance with enrichment factor of 667 folds, linear range of 1.0-400 ng/mL, limit of detection (LOD, S/N = 3) of 0.3 ng/mL, limit of quantification (LOQ, S/N = 10) of 1.0 ng/mL, and recoveries of 100.3-103.2 % (RSDs of 2.0-3.5 %) and 95.2-97.0 % (RSDs of 4.3-5.6 %) for tap water and lake water samples, respectively. SIGNIFICANCE: This is the first case to synthesize the large-size spherical COFs within 10-90 µm, and this work made it possible to directly use COFs as the filling materials of on-line SPE coupled to HPLC and HPLC. The developed analytical method can be potentially applied to the rapid and sensitive detection of trace bisphenol F in environmental water samples.

Marital quality improves self- and partner-reported psychopathy among Chinese couples: A longitudinal study.

BACKGROUND: Psychopathy is closely related to many negative interpersonal outcomes in daily life, including violence. Therefore, psychopathy intervention in subclinical individuals has significant application value. OBJECTIVE: Guided by the personality-relationship transaction model and social investment theory, this study examined how marital quality affects self- and partner-rated psychopathy. We also used the actor-partner interdependence mediation model to explore the mediating effect of communication. METHODS: We examined self-reports and partner reports of psychopathy, marital quality, and communication among 260 married Chinese couples. RESULTS: The results indicated that marital quality directly influenced couples' self-rated psychopathy, with both actor and partner effects on husbands' psychopathy and actor effects on wives' psychopathy. Moreover, verbal communication had mediating effects at time 2 between marital quality at time 1 and partner-reported psychopathy at time 3. Meanwhile, the mediating effect of nonverbal communication was not significant. CONCLUSION: Our investigation of relationship effects on psychopathy revealed that the underlying mechanisms differed between self- and partner-rated psychopathy. The findings can highlight directions for exploring potential intervention strategies for subclinical psychopathy.

Solid-State Electrolytes and Electrode/Electrolyte Interfaces in Rechargeable Batteries.

Solid-state batteries (SSBs) are considered to be one of the most promising candidates for next-generation energy storage systems due to the high safety, high energy density and wide operating temperature range of solid-state electrolytes (SSEs) they use. Unfortunately, the practical application of SSEs has rarely been successful, which is largely attributed to the low chemical stability and ionic conductivity, ineluctable solid-solid interface issues including limited ion transport channels, high energy barriers, and poor interface contact. A comprehensive understanding of ion transport mechanisms of various SSEs, interactions between fillers and polymer matrixes and the role of the interface in SSBs are indispensable for rational design and performance optimization of novel electrolytes. The categories, research advances and ion transport mechanism of inorganic glass/ceramic electrolytes, polymer-based electrolytes and corresponding composite electrolytes are detailly summarized and discussed. Moreover, interface contact and compatibility between electrolyte and cathode/anode are also briefly discussed. Furthermore, the electrochemical characterization methods of SSEs used in different types of SSBs are also introduced. On this basis, the principles and prospects of novel SSEs and interface design are curtly proposed according to the development requirements of SSBs. Moreover, the advanced characterizations for real-time monitoring of interface changes are also brought forward to promote the development of SSBs.

Large-size porous spherical 3D covalent organic framework for preconcentration of bisphenol F in water samples and orange juice.

Large-size spherical sorbents with particle size of 10-50 µm are widely applied in separation fields, however it is still a great challenge to synthesize such large-size spherical covalent organic framework (COF). In this work, a type of large-size porous 3D COF was size-controablly synthesized via a two-step strategy, in which a large-size porous 3D spherical polymer was prepared first through a Pickering emulsion polymerization using nano silica as the stabilizer, and subsequently it was converted into porous spherical 3D COF by a solvothermal method. The as-prepared porous spherical COF (COF-320 as a model) showed size-controllable uniform spherical morphology within 15-45 µm, large specific surface area, fine crystalline structure, and good chemical stability. When used as the sorbent for dispersive solid-phase extraction (d-SPE) of bisphenol F (BPF), the porous spherical COF-320 (15 µm) displayed high adsorption capacity (Qmax = 335.6 mg/g), high enrichment factor (80 folds), and good reusability (at least five cycles). By coupling the d-SPE method to HPLC, a new analytical approach was developed and successfully applied to the determination of trace BPF in two water samples, an orange juice and a standard sample with recoveries of 96.0-102.2 % (RSD = 1.1-1.5 %), 95.7-97.4 % (RSD = 1.4-4.4 %) and 98.7 % (RSD = 2.3 %), respectively. The limit of detection (S/N = 3) and limit of quantification (S/N = 10) were 0.1 and 0.3 ng/mL, respectively. The new synthesis strategy opens a viable way to prepare large-size porous spherical COFs, and the developed analytical method can be potentially applied to sensitively detect the trace BPF in water samples and beverages.

Efficacy and safety of gastroscopic hemostasis in the treatment of acute gastric hemorrhage: A meta-analysis.

BACKGROUND: Gastric cancer (GC) is a malignant tumor with a high incidence and mortality rate worldwide for which acute bleeding is a common clinical complication. Gastroscopic hemostasis is an important method for treating acute bleeding in GC; however, its efficacy and safety remain controversial. AIM: To systematically analyze the efficacy and safety of gastroscopic hemostasis for the treatment of acute gastric hemorrhage. METHODS: The PUBMED, Web of Science, Wiley Library, EMBASE, Wanfang, CNKI, and VIP databases were searched for studies related to gastroscopic hemostatic treatment for acute GC published through February 20, 2023. The literature was screened according to the inclusion and exclusion criteria, data were extracted, and literature quality was evaluated. The meta-analysis was performed using RevMan software (version 5.3), while Begg's test for publication bias was performed using Stata 13.0 software. RESULTS: Six randomized controlled trials and two retrospective analyses were retrieved. Five studies had a low, two had an uncertain, and one had a high risk of bias. Compared with the control group, the hemostatic rate of gastroscopic hemostasis was increased [relative risk (RR) = 1.24; 95% confidence interval (CI): 1.08 to 1.43; P = 0.003]; the rate of rebleeding (RR = 0.27; 95%CI: 0.09 to 0.80; P = 0.02), rate of surgery transfer (RR = 0.16; 95%CI: 0.06 to 0.43; P = 0.0003), serum C-reactive protein level [mean difference (MD) = -5.16; 95%CI: -6.11 to 4.21; P < 0.00001], interleukin-6 level (MD = -6.37; 95%CI: -10.33 to -2.42; P = 0.002), and tumor necrosis factor-α level (MD = -2.29; 95%CI: -4.06 to -0.52; P = 0.01) were decreased; and the quality of life improvement rate was increased (RR = 1.95; 95%C I= 1.41-2.71; P < 0.0001). Begg's test revealed no significant publication bias. CONCLUSION: The efficacy and safety of endoscopic hemostasis were higher than those of the control group, suggesting that it is an effective treatment for acute GC hemorrhage.

Ultrafast power Doppler imaging for ischemic encephalopathy: A case report.

BACKGROUND: Severely elevated intracranial pressure due to various reasons, such as decreased cerebral perfusion, can lead to devastating neurological outcomes, such as brain herniation. Decompression craniectomy is a life-saving procedure that is commonly performed for such a critical situation, but the changes in cerebral microvessels after brain herniation and decompression are unclear. Ultrafast power Doppler imaging (uPDI) is a new microvascular imaging technology that utilizes high frame rate plane/diverging wave transmission and advanced clutter filters. uPDI significantly improves Doppler sensitivity and can detect microvessels, which are usually invisible using traditional ultrasound Doppler imaging. CASE SUMMARY: In this report, uPDI was used for the first time to observe the brain blood flow of a hypoperfusion area in a 4-year-old girl who underwent decompression craniectomy due to refractory intracranial hypertension (ICP) after malignant brain tumor surgery. B-mode imaging was used to verify the increased densities of the cerebral cortex and basal ganglia that were observed by computed tomography. CONCLUSION: uPDI showed the local blood supplies and anatomical structures of the patient after decompressive craniectomy. uPDI is potentially a more intuitive and noninvasive method for evaluating the effects of severe ICP on cerebral microvessels.

High-efficiency plasmonic vortex generation with near-infrared bifunctional metasurfaces.

Plasmonic vortices have shown a wide range of applications in on-chip photonics due to their fascinating properties of the orbital angular momenta (OAM) and phase singularity. However, conventional devices to generate them suffer from issues of low efficiencies and limited functionalities. Here, we establish a systematic scheme to construct high-efficiency bifunctional metasurfaces that can generate two plasmonic vortices exhibiting distinct topological charges, based on a series of reflective meta-atoms exhibiting tailored reflection-phases dictated by both resonant and geometric origins. As a benchmark test, we first construct a meta-coupler with meta-atoms exhibiting geometric phases only, and experimentally demonstrate that it can generate a pre-designed plasmonic vortex at the wavelength of 1064 nm with an efficiency of 27% (56% in simulation). Next, we design/fabricate two bifunctional metasurfaces with meta-atoms integrated with both resonant and geometric phases, and experimentally demonstrate that they can generate divergent (or focused) or convergent (or defocused) plasmonic vortices with district OAM as shined by circularly polarized light with opposite helicity at 1064 nm wavelength. Our work provides an efficient platform to generate plasmonic vortices as desired, which can find many applications in on-chip photonics.

Association between maternal postpartum depression and children's physical growth in early childhood: a birth cohort study.

Background: Untreated maternal postpartum depression (PPD) has consequences for children's physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort. Methods: Between 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers' depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months. Results: A total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (ß = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (ß = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children. Limitations: The number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken. Conclusions: After adjustments for confounders, no dynamic association was found between PPD and children's weight and height growth. EPDS scores, in contrast, did negatively affect children's weight and height growth at age 1-3 months, but this effect was not long-lasting.

Aligned Dipoles Induced Electric-Field Promoting Zinc-Ion De-Solvation toward Highly Stable Dendrite-Free Zinc-Metal Batteries.

Water-induced parasitic reactions and uncontrolled dendritic Zn growth are long-lasting tricky problems that severely hinder the development of aqueous zinc-metal batteries. Those notorious issues are closely related to electrolyte configuration and zinc-ion transport behavior. Herein, through constructing aligned dipoles induced electric-field on Zn surface, both the solvation structure and transport behavior of zinc-ions are fundamentally changed. The vertically ordered zinc-ion migration trajectory and gradually concentrated zinc-ion achieved inside the polarized electric-field remarkably eliminate water related side-reactions and Zn dendrites. Zn-metal under the polarized electric-field demonstrated significantly improve reversibility and a dendrite-free surface with strong (002) Zn deposition texturing. Zn||Zn symmetric cell delivers greatly prolonged lifespan up to 1400 h (17 times longer than that of the cell based on bare Zn) while the Zn||Cu half-cell demonstrate ultrahigh 99.9% coulombic efficiency. NH4 V4 O10 ||Zn half-cell delivered exceptional-high 132 mAh g-1 capacity after ultralong 2000 cycles (≈100% capacity retention). In addition, MnO2 ||Zn pouch-cell under aligned dipoles induced electric-field maintains 87.9% capacity retention after 150 cycles under practical condition of high MnO2 mass loading (≈10 mg cm-2 ) and limited N/P ratio. It is considered that this new strategy can also be implemented to other metallic batteries and spur the development of batteries with long-lifespan and high-energy-density.

Evaluation of Early Diabetic Kidney Disease Using Ultrasound Localization Microscopy: A Feasibility Study.

OBJECTIVE: The purpose of this study is to detect the hemodynamic changes of microvessels in the early stage of diabetic kidney disease (DKD) and to test the feasibility of ultrasound localization microscopy (ULM) in early diagnosis of DKD. METHODS: In this study, streptozotocin (STZ) induced DKD rat model was used. Normal rats served as the control group. Conventional ultrasound, contrast-enhanced ultrasound (CEUS), and ULM data were collected and analyzed. The kidney cortex was divided into four segments, which are 0.25-0.5 mm (Segment 1), 0.5-0.75 mm (Segment 2), 0.75-1 mm (Segment 3), and 1-1.25 mm (Segment 4) away from the renal capsule, respectively. The mean blood flow velocities of arteries and veins in each segment were separately calculated, and also the velocity gradients and overall mean velocities of arteries and veins. Mann-Whitney U test was used for comparison of the data. RESULTS: Quantitative results of microvessel velocity obtained by ULM show that the arterial velocity of Segments 2, 3, and 4, and the overall mean arterial velocity of the four segments in the DKD group are significantly lower than those in the normal group. The venous velocity of Segment 3 and the overall mean venous velocity of the four segments in the DKD group are higher than those in the normal group. The arterial velocity gradient in the DKD group is lower than that in the normal group. CONCLUSION: ULM can visualize and quantify the blood flow and may be used for early diagnosis of DKD.

Microstructure Heterogeneity and Mechanical Properties of a High-Strength Ductile Laminated Steel by Electron Beam Welding.

The aim of this study is to fabricate high-strength steel with exceptional yield strength and superior ductility by employing a novel design approach of nanolamellar/equiaxial crystal "sandwich" heterostructures, utilizing rolling and electron-beam-welding techniques. The microstructural heterogeneity of the steel is manifested in the phase content and grain size, ranging from nanolamellae comprising a small quantity of martensite on both sides to the completely coarse austenite in the center, which are interconnected via gradient interfaces. The structural heterogeneity and phase-transformation-induced plasticity (TIRP) offer remarkable strength and ductility for the samples. Furthermore, the synergistic confinement of the heterogeneous structures leads to the formation of Lüders bands, which exhibit stable propagation under the TIRP effect and impede the onset of plastic instability, ultimately resulting in a significant improvement in the ductility of the high-strength steel.