432A perspective on light-based bioprinting of DNA hydrogels for advanced bone regeneration: Implication for bone organoids.

Light-based three-dimensional (3D) printing of hydrogels has been widely adopted for accelerating bone regeneration. However, the design principles of traditional hydrogels do not take into consideration the biomimetic regulation of multiple stages throughout the bone healing, and the hydrogels made cannot effectively induce sufficient osteogenesis, which in turn greatly limits their capacity in guiding bone regeneration. The recent progress achieved in DNA hydrogel, which is based on synthetic biology, could facilitate the innovation of the current strategy due to its advantages, such as resistance to enzymatic degradation, programmability, structural controllability, and mechanical properties. However, 3D printing of DNA hydrogel is not well defined and appears to have a few distinct early forms. In this article, a perspective on the early development of 3D printing of DNA hydrogels is presented, and a potential implication of the hydrogel-based bone organoids built-up for bone regeneration is proposed.

Correlation between food-specific IgG antibodies and phenotypes of chronic spontaneous urticaria / 中华皮肤科杂志

Objective:To investigate the correlation between food-specific IgG (sIgG) antibodies and phenotypes of chronic spontaneous urticaria (CSU) .Methods:Serum samples were collected from outpatients with active CSU, symptomatic dermographism (SD) , or acute urticaria (AU) , and healthy controls from 5 third-grade class-A hospitals such as the First Hospital of China Medical University between April 2014 and March 2015. Enzyme-linked immunosorbent assay was conducted to detect serum levels of 90 food-sIgG antibodies and total IgE, Western blot analysis to detect levels of 20 allergen-specific IgE antibodies, and chemiluminescent microparticle immunoassay to detect levels of anti-thyroid peroxidase IgG antibodies and anti-thyroglobulin IgG antibodies. Comparisons of normally distributed quantitative data between two groups and among several groups were performed by t test and one-way analysis of variance, respectively; comparisons of non-normally distributed quantitative data between two groups were performed by Mann-Whitney U test; for comparisons of proportions, chi-square test and Fisher′s exact test were used. Results:A total of 248 patients with CSU, 22 with SD, 15 with AU and 13 healthy controls were recruited. The cut-off level for sIgG positivity was 100 U/ml (at least 2+) , and the positive rate of food-sIgG antibodies was slightly higher in the patients with CSU (176/248, 70.97%) , SD (15/22, 68.18%) and AU (11/15) than in the healthy controls (7/13; χ2 = 1.80, P = 0.615) . Among the 248 CSU patients, the proportion of patients with family history of allergic diseases was significantly higher in the sIgG-positive group (71/176, 40.34%) than in the sIgG-negative group (19/72, 26.39%; χ2 = 4.30, P = 0.042) , while no significant difference was observed in the 1-day urticaria activity score (UASday) between the two groups ( Z = 0.18, P = 0.859) . Totally, 177 CSU patients completed 12- to 40-week treatment; their condition could be completely controlled by second-generation H1-antihistamines, and there was no significant difference in the required dosage of second-generation H1-antihistamines between the sIgG-positive group (128 cases) and sIgG-negative group (49 cases; Z = -1.06, P = 0.298) . Conclusions:The prevalence of family history of allergic diseases was relatively high in food-sIgG-positive patients with CSU. However, food-sIgG could not be used as an indicator to reflect the disease activity of CSU and treatment response.

Effects of neutrophil DNA methylation on periodontitis and research progress in bioinformatics / 国际生物医学工程杂志

Periodontitis is a chronic infectious disease leading to periodontal connective tissue destruction and alveolar bone resorption, which is widely prevalent and seriously endangers the oral and systemic health of a wide range of patients. The host immune inflammatory response plays a major role in the tissue destruction of periodontitis. Polymorphonuclear neutrophils (PMNs), as one of the important immune cell components in periodontal tissues, can trigger the host immune inflammatory response through the release of pro-inflammatory factors, which in turn leads to periodontitis. DNA methylation can influence the function of immune cells by regulating gene expression. Bioinformatics technology can provide new ideas for the treatment of periodontitis by analyzing the gene expression profiles and DNA methylation data of periodontal tissues from public databases of periodontitis patients and healthy populations, uncovering key DNA methylation genes of PMNs, and elucidating the influence of these genes on the pathological progression of periodontitis.

Advances in the study of the m6A methyltransferase METTL3 promoting bladder cancer progression via AFF4/NF-κB/MYC signaling network / 现代泌尿外科杂志

Bladder cancer (BCa) is one of the most common cancers in urology,whose pathogenesis is still unclear. Methyltransferase-like 3(METTL3) is the most important part of N6-methyladenosine methyltransferase complex (m6A MTC),which mediates the methylation of mRNA to regulate the stability and translation process of mRNA. Researches have shown that METTL3 can promote BCa development via AFF4/NF-κB/MYC signaling network,which involves many kinds of signaling molecules. In addition,METTL3 can affect the expressions of AFF4,NF-κB and MYC,so as to affect their downstream signaling pathways and finally promote the malignant progression of tumor.

Study of a fetus with confined placental mosaicism for trisomy 2 in conjunct with fetal uniparental disomy and a literature review / 中华医学遗传学杂志

OBJECTIVE@#To carry out genetic analysis for a fetus with confined placental mosaicism (CPM) for trisomy 2 (T2) in conjunct with fetal uniparental disomy (UPD).@*METHODS@#Amniocentesis and chromosomal karyotyping was carried out for a pregnant woman with a high risk for chromosome 2 anomalies indicated by non-invasive prenatal testing (NIPT). Single nucleotide polymorphism array (SNP-array) and trio-whole exome sequencing (Trio-WES) were carried out. Ultrasonography was used to closely monitor the fetal growth. Multifocal sampling of the placenta was performed after delivery for copy number variation sequencing (CNV-seq).@*RESULTS@#The fetus was found to have a normal chromosomal karyotype. SNP-array has revealed multiple regions with loss of heterozygosity (LOH) on chromosome 2. Trio-WES confirmed the presence of maternal UPD for chromosome 2. Ultrasonography has revealed intrauterine growth restriction and oligohydramnios. Intrauterine fetal demise had occurred at 23+4 weeks of gestation. Pathological examination had failed to find salient visceral abnormality. The placenta was proved to contain complete T2 by CNV-seq.@*CONCLUSION@#T2 CPM can cause false positive result for NIPT and may be complicated with fetal UPD, leading to adverse obstetric outcomes such as intrauterine growth restriction, oligohydramnios and intrauterine fetal demise.

Genetic analysis of a case of infant spinal muscular atrophy type 1c / 中国综合临床

Objective:To summarize the genetic characteristics of a case of spinal muscular atrophy type 1c.Methods:The case data of a child with spinal muscular atrophy type 1c was retrospectively analyzed, and the genetic analysis and literature review were carried out.Results:The patient, male, started at the age of 2 months, and showed gross motor development backwardness and low muscular tension. Multiplex connection probe amplification technique showed that the child had homozygous deletion mutation in exon 7-8 of SMN1 gene, and there was duplicate mutation in exon 7-8 of SMN2 gene. The number of copies of exon 7/8 was 3/3. His father was a heterozygous deletion carrier of SMN1 gene, and there was homozygous mutation in exon 8 of SMN2 gene. The number of copies of exon 7/8 was 2/3. His mother did not find abnormal exons of SMN1 gene, and the number of copies of exon 7/8 of SMN2 gene was 1/1.Conclusion:Spinal muscular atrophy lacks specific manifestations in the early stage, and the diagnosis mainly depends on genetic testing. Clinicians need to be vigilant, strengthen the early understanding of the disease, and improve the prognosis.

Effect of coronary microvascular dysfunction on cardiac mechanical indices in patients with non-obstructive coronary artery disease / 中华超声影像学杂志

Objective:To investigate the effect and relationship of coronary microvascular dysfunction (CMD) on cardiac mechanical indices in patients with non-obstructive coronary artery disease(NOCAD) in the resting state.Methods:This study was a single-center retrospective study. Seventy-nine NOCAD patients who hospitalized in Qilu Hospital of Shandong University from July 2017 to March 2022 were recruited. All patients underwent conventional echocardiography examination and the examination of coronary flow velocity reserved by transthoracic Doppler echocardiography (TTDE-CFVR). Based on the results of TTDE-CFVR, patients were divided into CMD group (CFVR<2.5, 32 cases) and a control group (CFVR≥2.5, 47 cases). Clinical data, routine echocardiographic parameters, regional mechanical indices including regional myocardial work index(RWI) and regional longitudinal strain(RLS), global mechanical indices including left ventricular global longitudinal strain(GLS), global longitudinal strain in the endocardial layer(GLS-endo), global longitudinal strain in the epicardial layer(GLS-epi), left ventricular global work index(GWI), global contractive work(GCW), global waste work(GWW), global work efficiency(GWE) were compared between two groups. Binary logistic regression was used to analyze the risk factors of CMD. ROC curve was used to construct a prediction model for CMD.Results:There was no significant difference in sex ratio, BMI, smoking history, diabetes, hypertension and dyslipidemia between CMD group and control group. Age was significantly higher in the CMD group than in the control group. RWI, GWI, GCW, GWE and the absolute values of RLS, GLS, GLS-endo and GLS-epi were significantly lower in the CMD group than in the control group. Logistic regression analysis showed that the decrease of absolute value of GLS was an independent risk factor for the CMD( OR=1.335, 95% CI=1.041-1.713, P=0.023). ROC curve showed that myocardial strain-related indexes had a good decrease value for the CMD. Conclusions:For patients with NOCAD, the presence of CMD is associated with the decrease of left ventricular regional and global systolic function.

Prospective study of apatinib combined with chemoradiotherapy for head and neck squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.

Fucoidan-functionalized activated platelet-hitchhiking micelles simultaneously track tumor cells and remodel the immunosuppressive microenvironment for efficient metastatic cancer treatment

Tumor metastasis is responsible for most mortality in cancer patients, and remains a challenge in clinical cancer treatment. Platelets can be recruited and activated by tumor cells, then adhere to circulating tumor cells (CTCs) and assist tumor cells extravasate in distant organs. Therefore, nanoparticles specially hitchhiking on activated platelets are considered to have excellent targeting ability for primary tumor, CTCs and metastasis in distant organs. However, the activated tumor-homing platelets will release transforming growth factor-β (TGF-β), which promotes tumor metastasis and forms immunosuppressive microenvironment. Therefore, a multitalent strategy is needed to balance the accurate tumor tracking and alleviate the immunosuppressive signals. In this study, a fucoidan-functionalized micelle (FD/DOX) was constructed, which could efficiently adhere to activated platelets through P-selectin. Compared with the micelle without P-selectin targeting effect, FD/DOX had increased distribution in both tumor tissue and metastasis niche, and exhibited excellent anti-tumor and anti-metastasis efficacy on 4T1 spontaneous metastasis model. In addition, due to the contribution of fucoidan, FD/DOX treatment was confirmed to inhibit the expression of TGF-β, thereby stimulating anti-tumor immune response and reversing the immunosuppressive microenvironment. The fucoidan-functionalized activated platelets-hitchhiking micelle was promising for the metastatic cancer treatment.

Podocyte RNF166 deficiency alleviates diabetic nephropathy by mitigating mitochondria impairment and apoptosis via regulation of CYLD signal.

Diabetic nephropathy (DN) is a major cause of renal failure in diabetic patients. RING-finger protein 166 (RNF166), composed of an N-terminal RING domain and C-terminal ubiquitin interaction motif, plays a critical role in mediating various cellular processes. However, its potential in DN has not been investigated. In the present study, we found that DN patients exhibited significantly increased expression of RNF166 in renal tissues compared with the normal individuals, and abundant RNF166 was detected in podocytes. We then showed that podocyte-conditional RNF166 knockout (RNF166cKO) markedly reduced blood glucose levels and ameliorated renal dysfunction in streptozotocin (STZ)-induced diabetic mice. Additionally, abnormal histological changes and podocyte injury were observed in STZ-induced diabetic mice, while being markedly ameliorated by RNF166cKO. Furthermore, podocyte-specific RNF166 deficiency considerably mitigated apoptosis and mitochondrial impairments in glomeruli podocytes of STZ-challenged mice through suppressing Caspase-3 cleavage and improving mitochondrial fission-associated molecules. In vitro studies further confirmed that high glucose (HG) induced mitochondrial dysfunction, along with enhanced releases of Cyto-c from mitochondria and elevated expression of cleaved Caspase-9, contributing to intrinsic apoptosis in podocytes. Intriguingly, these effects triggered by HG were dramatically ameliorated by RNF166 knockout. Mechanistically, we demonstrated that RNF166 directly interacted with cylindromatosis (CYLD), and negatively regulated CYLD expression. Notably, RNF166 knockout-attenuated mitochondrial damage and apoptosis were mainly through CYLD in podocytes upon HG stimulation. Together, all these findings provided new insights into the novel effects of RNF166 on maintaining mitochondrial function and apoptosis in podocytes during DN progression both in vivo and in vitro through interacting with CYLD, indicating that RNF166/CYLD may be an innovative therapeutic target for developing effective strategy against DN development.

Advances in research on family resilience in cancer patients / 中国实用护理杂志

To summarize the correlation study of family resilience, family resilience factors study, theoretical model and application study of family resilience, family resilience assessment tools in cancer patients, and prospect future research on family resilience in cancer patients. This study aims to provide reference for future research directions on family resilience in cancer patients.

Efficacy of a cooling gel containing calcium-based antimicrobial peptide compounds combined with desonide cream in the treatment of atopic dermatitis in children: a randomized, double-blind controlled clinical study / 中华皮肤科杂志

Objective:To evaluate short-term clinical efficacy and safety of a cooling gel containing calcium-based antimicrobial peptide compounds (CAPCS cooling gel) combined with desonide cream in the treatment of atopic dermatitis (AD) in children.Methods:From November 2019 to September 2020, a randomized, double-blind controlled clinical trial was conducted in 60 children with AD enrolled from Department of Dermatology and Venereology, West China Hospital, Sichuan University. The 60 patients were randomly and equally divided into 2 groups: test group treated with topical desonide cream in the morning and evening as well as topical CAPCS cooling gel at noon during the first 3 days of treatment, followed by topical CAPCS cooling gel in the morning, at midday and in the evening for 11 days; control group treated with topical desonide cream in the morning and evening as well as topical CAPCS-free placebo gel at noon during the first 3 days of treatment, followed by topical CAPCS-free placebo gel in the morning, at midday and in the evening for 11 days. The treatment lasted 2 weeks. Finally, 56 AD patients completed the follow-up, and 28 in each group were included into the following analysis. Clinical indices, such as eczema area and severity index (EASI) , visual analogue scale (VAS) , investigator′s global assessment (IGA) and dermatology life quality index (DLQI) , were recorded before, 7 ± 3 days and 14 ± 3 days after the treatment, so were adverse reactions.Results:After 1-week treatment, 1 patient in the test group and 1 in the control group showed response to the treatment, with the response rate being 3.57% in both groups; after 2-week treatment, 12 patients in the test group and 2 in the control group showed response to the treatment, with response rates being 42.86% and 7.14% respectively; there were significant differences in the treatment outcomes between the two groups after 1- and 2-week treatment ( Z = -4.318, -5.474, respectively, both P < 0.05) . There was no significant difference in the EASI, VAS, IGA or DLQI score between the two groups before treatment (all P > 0.05) ; nonparametric Friedman test showed a significant difference in the changing trend of the EASI score over time between the two groups ( χ2 = 45.720, P < 0.05) . Two-way repeated measurement analysis of variance showed a significant difference in the VAS score ( F = 10.738, P = 0.002) , but no significant difference in IGA or DLQI score between the test group and control group after 1-week treatment ( F = 0.066, 0.804, P = 0.135, 0.374, respectively) ; after 2-week treatment, there were significant differences in the VAS, IGA and DLQI score between the 2 groups ( F = 67.313, 38.949, 51.503, respectively, all P < 0.001) . During the clinical study period, 1 adverse event occurred in the test group and control group each, which manifested as tingling or irritating sensation at the topically treated sites, and there was no significant difference in the incidence rate of adverse events between the two groups ( P > 0.05) . Conclusion:Short-term topical application of CAPCS cooling gel combined with desonide cream is effective for the treatment of AD in children, and does not increase the incidence of adverse reactions compared with the placebo.

Cytogenetic and molecular genetic analysis of Klinefelter syndrome in a fetus of Duchenne muscular dystrophy family / 中华围产医学杂志

A 44-year-old pregnant woman (G5P3) who had delivered two children with DMD was admitted and underwent prenatal diagnosis at Peking Union Medical College Hospital in 2019. (1) The karyotype of the fetus in 2019 was 47,XXY. The fluorescence in situ hybridization (FISH) result showed a nucish(CSPX×2, CSPY×1)[100] and multiplex ligation-dependent probe amplification (MLPA) suggested sex chromosome abnormality. Based on the above results, the fetus was diagnosed with Klinefelter syndrome. Fetal short tandem repeat (STR) linkage analysis and Sanger sequencing indicated a heterozygous mutation of c.9543delG(p.Trp3181CysfsTer2). (2) Sanger sequencing of the proband found a novel frameshift mutation of c.9543delG(p.Trp3181CysfsTer2 ) in exon 65 of the DMD gene. (3) The male fetus performing prenatal diagnosis in 2008 was found to have the same maternal gene markers as the proband with the same genotype. While the genotype of the fetus in 2009 obtained a different maternal gene marker from the proband and did not detect the same DMD gene mutation. This fetus was delivered at full term and was good during follow-up. (4) The elder brother and cousin of the proband had the same frameshift mutation in exon 65 of the DMD gene as the proband. The mother of the proband was a heterozygous carrier of the mutation.

The ACE2 expression of maternal-fetal interface and fetal organs indicates potential risk of vertical transmission of SARS-COV-2

Recent studies have demonstrated that SARS-CoV-2 cell entry depends on both ACE2 and TMPRSS2 genes (DOI: 10.1016/j.cell.2020.02.052), but our current work only focus on ACE2, which is insufficient to support the conclusion of this paper. So the authors have withdrawn their manuscript whilst they perform additional experiments and analysis to test some of their conclusions further. Therefore, the authors do not wish this work to be cited as reference for the project.

Impact of maternal X chromosome aneuploidies on cell free DNA prenatal screening / 中华妇产科杂志

Objective:To investigate the impact of maternal X chromosome aneuploidies on cell free DNA (cf-DNA) prenatal screening.Methods:After genetic counseling, invasive prenatal diagnosis was provided for the 124 cases with high risk of sex chromosome aneuploidie (SCA) indicated by cf-DNA prenatal screening. For cases with discordant results of fetal prenatal diagnosis and cf-DNA prenatal screening, maternal leukocyte was collected for copy number variation sequencing (CNV-seq) to detect whether the maternal X chromosome was carrying variations.Results:Totally, 124 cases with high risks of SCA indicated by cf-DNA prenatal screening, 9 cases refused to take invasive prenatal diagnosis, while the remaining 115 cases received. Among the 115 cases, 41 cases received accordant results with cf-DNA prenatal screening while 74 cases discordant. Among the 74 cases with discordant results, 19 cases were indicated with maternal X chromosome variations by maternal leukocyte CNV-seq, which accounting for 25.7% (19/74) of the SCA false positive cases, and 15.3% (19/124) of all SCA cases.Conclusions:Pregnant women with X chromosome variations may affect the results of cf-DNA prenatal screening, resulting in false positive or false negative outcomes, it should be emphasized that the cf-DNA results may be affected by maternal X chromosome variations. In cases with discordant results of prenatal diagnosis and cf-DNA prenatal screening, maternal leukocyte CNV-seq is recommended to find the reasons of false positive or negative results. And cf-DNA prenatal screening is not recommended for pregnant women who are already known with X chromosome variations.

Impact of maternal X chromosome aneuploidies on cell free DNA prenatal screening / 中华妇产科杂志

Objective@#To investigate the impact of maternal X chromosome aneuploidies on cell free DNA (cf-DNA) prenatal screening.@*Methods@#After genetic counseling, invasive prenatal diagnosis was provided for the 124 cases with high risk of sex chromosome aneuploidie (SCA) indicated by cf-DNA prenatal screening. For cases with discordant results of fetal prenatal diagnosis and cf-DNA prenatal screening, maternal leukocyte was collected for copy number variation sequencing (CNV-seq) to detect whether the maternal X chromosome was carrying variations.@*Results@#Totally, 124 cases with high risks of SCA indicated by cf-DNA prenatal screening, 9 cases refused to take invasive prenatal diagnosis, while the remaining 115 cases received. Among the 115 cases, 41 cases received accordant results with cf-DNA prenatal screening while 74 cases discordant. Among the 74 cases with discordant results, 19 cases were indicated with maternal X chromosome variations by maternal leukocyte CNV-seq, which accounting for 25.7% (19/74) of the SCA false positive cases, and 15.3% (19/124) of all SCA cases.@*Conclusions@#Pregnant women with X chromosome variations may affect the results of cf-DNA prenatal screening, resulting in false positive or false negative outcomes, it should be emphasized that the cf-DNA results may be affected by maternal X chromosome variations. In cases with discordant results of prenatal diagnosis and cf-DNA prenatal screening, maternal leukocyte CNV-seq is recommended to find the reasons of false positive or negative results. And cf-DNA prenatal screening is not recommended for pregnant women who are already known with X chromosome variations.

Strategy and practice of standardized residency training management during the national outbreak of COVID-19 / 中华医学教育探索杂志

The national outbreak of coronavirus disease 2019 (COVID-19) has brought a severe challenge to the management of standardized residency training (SRT). To protect SRT residents from being infected by 2019 novel coronavirus (2019-nCoV), to guarantee the training program well carried out, and to prevent psychological health problems are conundrums to the management of SRT. In this article, the specific countermeasures are introduced from the following aspects: perfecting the management system, implementing quarantine and life support, conducting epidemic prevention and control training, turning training patterns suitable to epidemic prevention, and maintaining the psychological health of the residents. And we expect to provide references for SRT management under the public health emergency in the future.

A spike denoising method combined principal component analysis with wavelet and ensemble empirical mode decomposition / 生物医学工程学杂志

Spike recorded by multi-channel microelectrode array is very weak and susceptible to interference, whose noisy characteristic affects the accuracy of spike detection. Aiming at the independent white noise, correlation noise and colored noise in the process of spike detection, combining principal component analysis (PCA), wavelet analysis and adaptive time-frequency analysis, a new denoising method (PCWE) that combines PCA-wavelet (PCAW) and ensemble empirical mode decomposition is proposed. Firstly, the principal component was extracted and removed as correlation noise using PCA. Then the wavelet-threshold method was used to remove the independent white noise. Finally, EEMD was used to decompose the noise into the intrinsic modal function of each layer and remove the colored noise. The simulation results showed that PCWE can increase the signal-to-noise ratio by about 2.67 dB and decrease the standard deviation by about 0.4 μV, which apparently improved the accuracy of spike detection. The results of measured data showed that PCWE can increase the signal-to-noise ratio by about 1.33 dB and reduce the standard deviation by about 18.33 μV, which showed its good denoising performance. The results of this study suggests that PCWE can improve the reliability of spike signal and provide an accurate and effective spike denoising new method for the encoding and decoding of neural signal.

Use of echocardiography to monitor myocardial damage during anthracycline chemotherapy.

BACKGROUND: Anthracycline-related cardiotoxicity has a poor prognosis; therefore, early detection of any change in LV function is critical. OBJECTIVE: The aim of this study was to evaluate the two-dimensional speckle tracking technique for the early detection of cardiac toxicity after low-dose anthracycline chemotherapy in the Chinese population. METHODS: Forty breast cancer patients were treated by chemotherapy using anthracycline for 4-6 cycles. Patients were examined by echocardiography before chemotherapy (T0) and after the second (T2), fourth (T4), and sixth (T6) cycle. LV ejection fraction (LVEF), LV global longitudinal strain (GLS) and endocardium, mid-myocardium, and epicardium global longitudinal strain (GLS-Endo, GLS-Mid, and GLS-Epi). Additionally, global circumferential strain (GCS), RV global longitudinal strain (RVGLS), and LA global longitudinal strain (LAGLS) were evaluated. RESULTS: Left ventricular ejection fraction was significantly reduced at T4 (P < 0.05). Compared with T0, GLS, GLS-Endo, GLS-Mid, and GLS-Epi were significantly reduced at T2, T4, and T6 (P < 0.05 for all), the apical septum wall (AS) was also reduced significantly at T2 (P < 0.05), and the apical anterior wall (AA) and the basal anterior wall (BA) longitudinal strains were significantly reduced at T4 (P < 0.05). GCS, RVGLS, and LAGLS were not significantly changed after treatment (P > 0.05). CONCLUSIONS: LV stratified strains and strain of the segments supplied by the left anterior descending coronary artery are more sensitive to the cardiac toxicity of anthracycline.

Application of vector flow mapping technique in the assessment of left intraventricular pressure gradients in heart failure patients / 中华超声影像学杂志

Objective@#To evaluate the changes of intraventricular pressure differences (IVPDs) and intraventricular pressure gradients (IVPGs) in different phases of cardiac cycle in patients with heart failure(HF) patients by relative pressure imaging based on vector flow imaging(VFM).@*Methods@#Forty-nine HF patients with left ventricular ejection fraction (LVEF) lower than 0.50 hospitalized in Qilu Hospital of Shandong University from November 2018 to January 2019, including thirty-three patients with HF with reduced ejection fraction (HFrEF group) and fifteen patients with midrange ejection fraction (HFmrEF group), and forty-three controls were enrolled in this study. Clinical data and echocardiographic images were collected and the conventional left ventricular diameter, mass, volume, and systolic and diastolic function parameters were measured. IVPDs and IVPGs during isovolemic systole (IC), rapid ejection (RE), isovolemic diastole (IR), rapid filling (RF) and atrial systole (AC) phases were obtained by the VFM technique. The changes of IVPDs and IVPGs in different phases between the HF and control groups, and their correlations with conventional ultrasound parameters were analyzed.@*Results@#IVPDs and IVPGs in heart failure group were significantly reduced compared with the control group especially in isovolumic relaxation phase(all P<0.001). IVPDs and IVPGs showed a decreasing trend in the control group, HFmrEF group and the HFrEF group(P<0.001). IVPDs and IVPGs were correlated with LVID, LVMI, ESV, LVEF, GLS and E/e′ (all P<0.01), among which IVPD-IR and IVPG-IR were best correlated. IVPD-IR and IVPG-IR had excellent diagnostic efficacy for HF patients with LVEF<0.5, with cut-off values of <0.73 mmHg (AUC=0.915, P<0.001) and <0.103 mmHg/cm (AUC=0.932, P<0.001), respectively.@*Conclusions@#Early diastolic hemodynamics are severely impaired when systolic function declines.IVPG-IR, as a marker of left ventricular diastolic function, significantly correlates with left ventricular systolic function, and can be used as a potential indicator for assessing left ventricular systolic and diastolic function in patients with heart failure and identifying patients with heart failure.